Twentieth Century History of Findlay and Hancock County, Ohio, and Representative Citizens, Part 97

Author: Jacob Anthony Kimmell
Publication date: 1910
Publisher:
Number of Pages: 1189


USA > Ohio > Hancock County > Findlay > Twentieth Century History of Findlay and Hancock County, Ohio, and Representative Citizens > Part 97


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American Practice of Surgery. A Complete System of the Science and Art of Surgery. By Representative Surgeons of the United States and Canada. Editors: JOSEPH D. BRYANT, M. D., LL. D .; ALFRED H. BUCK, M. D. Complete in eight re- umes, profusely illustrated. Vol. VI. (New York: William Wood & Co., 1909.)


The surgeons, who contribute articles to this volume, are: Art- strong, Elder and Shepherd, of Montreal; Balch, Cabot, Grafes and Mosher, of Boston; Carson and Mudd, of St. Louis; Blood- good, of Baltimore, and Turner, of Philadelphia. Unless one turas to the individual articles there is no means of quickly finding the respective authors, whose names might have readily been placed after the subject headings under "Contents." Bloodgood's paper on the "Surgical Diseases of the Jaws " is separated from other papers on the surgery of the face and throat by a number of papers on the surgery of the female and male genitals. These are minor defects, but in a well-arranged system they would not occur. The very completeness of this sytem leads to redundancy of material. The volume opens with a paper on Prosthesis in its Relation to Surgery of the Face, Mouth, Jaws and Nasal and Laryngeal Cavities, followed in sequence by chapters on Surgical Diseases and Wounds of the Nasal Cavities and Accessory Sinuses; Surgical Diseases and Wounds of the Mouth, Tongue, and Salivary Glands; Surgical Diseases and Wounds of the Neck; Surgical Dis- eases and Wounds of the Thyroid and Thymus; Surgery of the Thorax and Spinal Column; Surgical Diseases and Wounds of the Female Breast; Surgical Diseases and Wounds of the Externa! Genitals and Vagina of the Female; Surgical Diseases and Wounds of the Male Genital Organs; Chancroid; Gonorrheal Urethritis, and Surgical Diseases and Wounds of the Jaws. Thus these articles take up 900 pages and the volume is so heavy as to be unwieldy. There are but few references, which seems rather a defect in a classical work of this nature, but the question of mul-


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acusted one. Many of the drawings and lotographs are excellent, but the colored plates are not good. ne articles, on the whole, cover the ground well, and the surgeon need of this system will find it a useful book. This volume may said to well uphold the repute already gained by American and inadian surgeons, and while there is no paper of exceptional erit in this volume, the general average of excellence is high.


ydrotherapy. A Work on Hydrotherapy in General, Its Applica- tion to Special Affections, The Technic or Processes Employed and the Use of Waters Internally. By GUY HINSDALE, A. M., M. D., etc. Illustrated. Price, $3.50. (Philadelphia and Lon- don: W. B. Saunders Company, 1910.)


A few years ago the number of text-books on this subject was nited, but they are now constantly increasing in numbers, and ere is no longer any reason why the general practitioner should it have a clear idea of the uses and value of water applied both ternally and externally. The best part of most of these text- oks is the description of the technic in giving the different forms baths and sprays. The authors have a tendency, it seems to us, exaggerate the value of water in many affections, but it must be id that those who do not use hydrotherapy freely do not recog- ze its many values. This work is a smaller one than Kellogg's, id sufficient for the use of the ordinary practitioner. The chap- r on the use of baths in typhoid fever, where correct use of ater is so important, is, however, most unsatisfactory, it is far


too brief, and the author should have given a fuller account of their action, and when they should and should not be given.


It is a pity to add to our medical terms such words as " Crouno- therapy " and "Crenology," which are really not needed, and the same figure with slightly different description is given on pages 73 and 245.


The Mental Symptoms of Brain Diseases-An Aid to the Surgical Treatment of Insanity, Due to Injury, Hemorrhage, Tumors and Other Circumscribed Lesions of the Brain. By BERNARD HOLLANDER, M. D. With Preface by Dr. Jul. Morel. Price $2. (New York: Rebman Company, 1910.)


In this work the author has classified a large number of cases taken from the literature under lesions of the different lobes depending on the nature of the symptoms shown. Under lesions of the frontal lobes he groups cases where the higher intellectual operations or the centers of perception and special memories or the higher human sentiments seem to be most affected. Cases of melancholia are grouped under lesions of the parietal lobes; and others of violent and homicidal mania fall under lesions of the temporal lobes, and so on. Such a classifica- tion as all neurologists know cannot be exact, for symptoms are not always clear cut, but one group shades into another, and an exact diagnosis of the site of the lesion cannot be made: The book, if used with thought, may, however, be helpful as a guide to students in their earlier studies of brain lesions.


BOOKS RECEIVED.


Text-Book of Bacteriology. A Practical Treatise for Students and Practitioners of Medicine. By Philip Hanson Hiss, Jr., M. D., and Hans Zinsser, M. D. With one hundred and fifty- six illustrations in the text, some of which are colored. 1910. 8vo. 745 pages. D. Appleton and Company, New York and London.


seases of Infants and Children. By Edmund Cautley, M. D., Cantab., F. R. C. P. Lond. 1910. 8vo. 1042 pages. Paul B. Hoeber, New York.


e Sexual Disabilities of Man and Their Treatment. By Arthur Cooper. Second edition, revised and enlarged. 1910. 16mo. 204 pages. Paul B. Hoeber, New York.


inary Surgery. A Review. By Frank Kidd, M. D., B. C. (Can- tab.), F. R. C. S. 1910. 8°. 429 pages. Longmans, Green and Company, London, New York, Bombay and Culcutta.


uses of Evolution and Heredity. By David Berry Hart, M. D., F. R. C. P. E. 12mo. 259 pages. Rebman Company, New York.


: Principles and Practice of Medicine. By William Osler, M. D., F. R. S. Seventh edition. Translated by Philip B. Cousland, M. B., C. M., Edin. 1910. 8vo. Publication Committee, China Medical Missionary Association, Shanghai.


Anatomical and Surgical Study of Fractures of the Lower End of the Humerus. By Astley Paston Cooper Ashhurst, A. B., M. D. The Samuel D. Gross Prize Essay of the Phila- delphia Academy of Surgery, 1910. 8vo. 163 pages. Lea & Febiger, Philadelphia and New York.


fanual of Nursing. By Margaret Frances Donahoe. Illus- [rated. 1910. 12mo. 489 pages. D. Appleton and Company, New York and London.


rt of the Surgeon-General, United States Army, to the Secre- ary of War, 1910. Annual Reports, War Department. Fiscal year ended June 30, 1910. 8vo. 223 pages. Government Printing Office, Washington.


Recherches d'Anatomie Chirurgicale sur les Artères de l'Abdomen; Le Trona Coelicque. Par Pierre Descomps. 1910. 4º. 205 pages. G. Steinheil, Paris.


Elements d'Anatomie Pathologique. Par L. Beriel. Avec 232 figures dessinées par le l'auteur. 8vo. 563 pages. G. Stein- heil, Paris.


Urgent Surgery. By Felix Lejars. Translated from the sixth French edition by William S. Dickie, F. R. C. S. With 20 full-page plates and 994 illustrations, of which 602 are drawn by Dr. E. Daleine and A. Leuba, and 217 are from original photographs. Vol. II. The Genito-Urinary Organs- The Rectum and Anus-the Strangulated Hernias-the Ex- tremities. 1910. 4to. 580 pages. William Wood and Com- pany, New York.


The Mental Symptoms of Brain Disease. An Aid to the Surgical Treatment of Insanity. due to Injury, Hæmorrhage, Tumors and other Circumscribed Lesions of the Brain. By Bernard Hollander, M. D. With preface by Dr. Jul. Morel. [1910.] 12mo. 237 pages. Rebman Company, New York.


The Modern Treatment of Alcoholism and Drug Narcotism. By C. A. McBride, M. D., L. R. C. P. & S. (Edin.) [1910]. 12mo. 376 pages. Rebman Company, New York.


Hints for the General Practitioner in Rhinology and Laryngology. By Dr. Johann Fein. Translated by J. Bowring Horgan, M. B., B. Ch. With forty figures in the text and two photo- graphic plates. [1910.] 12mo. 223 pages. Rebman Com- pany, New York.


Anemia. By Geh. Obermedizinalrat Professor Dr. P. Ehrlich and Dr. A. Lazarus. Volume 1. Part 1. Normal and Patho- logical Histology of the Blood. Second edition (enlarged and to a great extent rewritten), by Dr. A. Lazarus and Dr. O. Naegeli. Translated from the German by H. W. Armit, M. R. C. S., L. R. C. P. (London). With 5 illustrations in the text and 5 colored plates. 1910. 8vo. 218 pages. Rebman Company, New York.


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Diagnosis and Treatment of Diseases of Women. By Harry Sturgeon Crossen, M. D. Second edition, revised and en- larged. With seven hundred and forty-four engravings. 1910. 8vo. 1025 pages. C. V. Mosby Company, St. Louis.


Dispensing Made Easy. With Numerous Formula, and Practical Hints to Secure Simplicity, Rapidity and Economy. By Wm. G. Sutherland, M. B. Aberd. Fourth edition, revised by F. J. Warwick, B. A., M. B. Cantab., M. R. C. S., L. S. A. 1910. 16°. 102 pages. John Wright & Sons, Ltd., Bristol; Simpkin, Marshall, Hamilton, Kent and Co., Ltd., London.


The Diseases of China, Including Formosa and Korea. By W. Hamilton Jefferys, A. M., M. D., Univ. of Pennsylvania, and James L. Maxwell, M. D. London. With 5 colored plates, 11 nosogeographical plates, and 360 illustrations in the text. 1910. 8vo. 716 pages. P. Blakiston's Son & Co., Philadelphia.


Modern Treatment. The Management of Disease with Medicinal and Non-Medicinal Remedies. In Contributions by American and Foreign Authorities. Edited by Hobart Amory Hare, M. D. Assisted by H. R. M. Landis, M. D. In Two Volumes. Volume I. Illustrated. 1910. 8vo. 930 pages. Lea & Febiger, Philadelphia and New York.


The Racial Anatomy of the Philippine Islanders. Introducing New Methods of Anthropology and Showing their Application to the Filipinos with a Classification of Human Ears and a Scheme for the Heredity of Anatomical Characters in Man. By Robert Bennett Bean, B. S., M. D. With nineteen illus- trations reproduced from original photographs. Seven figures. 1910. 8vo. 236 pages. J. B. Lippincott Company, Phila- delphia and London.


Progressive Medicine. A Quarterly Digest of Advances, Dis- coveries and Improvements in the Medical and Surgical Sciences. Edited by Hobart Amory Hare, M. D., assisted by Leighton F. Appleman, M. D. Volume IV. December, 1910. 8vo. 360 pages. Lea & Febiger, Philadelphia and New York. Scientific Memoirs. New Series, No. 38. By Officers of the Medi- cal and Sanitary Departments of the Government of India. Preliminary Report on the Killing of Rats and Rat Fleas by Hydrocyanic Acid Gas. By Captain W. D. H. Stevenson, M. B., I. M. S. 1910. Fol. 28 pages. Superintendent Govern- ment Printing, Calcutta, India.


An Introduction to Surgery. By Rutherford Morison, M. A., M. B., F. R. C. S. Edin and Eng. With 146 illustrations in the text, and 5 colored plates. 1910. 4to. John Wright & Sons, Ltd., Bristol; Simpkin, Marshall, Hamilton, Kent & Co., Ltd., London.


Practical Bacteriology, Blood Work and Animal Parasitology. Including Bacteriological Keys, Zoological Tables and Ex- planatory Clinical Notes. By E. R. Stitt, A. B., Ph. G., M. D. Second edition, revised and enlarged with 91 illustrations. 1910. 12º. 345 pages. P. Blakiston's Son & Co., Phila- delphia.


International Clinics. A Quarterly of Illustrated Clinical Lec- tures and Especially Prepared Original Articles. Edited by Henry W. Cattell, A. M., M. D. Volume IV. Twentieth Series, 1910. 8vo. 308 pages. J. B. Lippincott Company, Philadelphia.


Principles of Therapeutics. By A. Manquat. Translated by M. Simbad Gabriel, M. D. 1910. 8vo. 298 pages. D. Appleton and Company, New York and London.


Clinical Pathological in Practice. With a Short Account of Var cine-Therapy. By Thomas J. Horder, B. Sc., M. D., F. R. C2 1910. 8vo. 216 pages. Oxford Medical Publications. Hezy Frowde, London; Hodder & Stoughton, London.


Puerperal Infection. By Arnold W. W. Lea, M. D., B. S. (Lond) B. Sc. (Manch.), F. R. C. S. (Eng.). 1910. 8vo. 384 paz Oxford Medical Publications. Henry Frowde, London; Hit der & Stoughton, London.


Induced Cell-Reproduction and Cancer. The Isolation of the Chemical Causes of Normal and of Augmented, Asymmetrin Human Cell-Division. By Hugh Campbell Ross, M. R. C.S (Eng.), L. R. C. P. (Lond.). Being the results of researches carried out by the author with the assistance of John Westry Cropper, M. B., M. Sc. (Liv.), M. R. C. S. (Eng.), L. R. C.P (Lond.). With 129 illustrations. 1911. 8vo. 423 pages P. Blakiston's Son & Co., Philadelphia.


Emanuel Swedenborg's Investigations in Natural Science and fk Basis for His Statements Concerning the Functions of tir Brain. By Martin Ramström. 1910. 4to. 59 pages. ['ai- versity of Upsala.


Studies in Invalid Occupation. A Manual for Nurses and !: tendants. By Susan E. Tracy. 1910. 8vo. 175 pagas Whitcomb & Barrows, Boston.


Nurses Handbook of Drugs and Solutions. By Julia C. Stimsa R. N. 1910. 12º. 82 pages. Whitcomb & Barrows, Bostor


A Text-Book of General Bacteriology. By Edwin O. Jorda: Ph. D. Second edition, thoroughly revised. Fully illustrated. 1910. 8vo. 594 pages. W. B. Saunders Company, Phila- delphia and London.


The Practice of Surgery. By James Gregory Mumford, M.D. With 682 illustrations. 1910. 8vo. 1015 pages. W. B Saunders Company, Philadelphia and London.


Hydrotherapy. A Work on Hydrotherapy in General, its Appli- cation to Special Affections, the Technique or Processes En- ployed, and the Use of Waters Internally. By Guy Hinsdale. A. M., M. D. Illustrated. 1910. 8vo. 466 pages. W. B. Saunders Company, Philadelphia and London.


Treatise on Diseases of the Skin. By Henry W. Stelwagon, M. D. Ph. D. Sixth edition, thoroughly revised. With 289 illustri tions in the text, and 34 full-page colored and half-tone plates. 1910. 8vo. 1195 pages. W. B. Saunders Company. Philadelphia and London.


Dawn of the Fourth Era in Surgery. And Other Short Articles Previously Published. By Robert T. Morris, A. M., M. D. 1910. 12º. 145 pages. W. B. Saunders Company, Phila- delphia and London.


Transactions of the American Gynecological Society. Volume 35. For the year 1910. 8vo. 566 + LXII pages. Philadelphia Transactions of the Congress of American Physicians and Sur- geons. Eighth Triennial Session held at Washington, D. C. May 3 and 4, 1910. 8vo. 456 pages. Published by the Cor- gress, New Haven, Conn.


The Harvey Lectures. Delivered Under the Auspices of the Harvey Society of New York, 1909-1910. By Prof. Richard M. Pearce, Prof. Otto Cohnheim, Prof. T. G. Brodie, Prof. G. Carl Huber, Prof. Ludwig Hektoen, Prof. Eugene L. Opie. Prof. Adolf Meyer, Prof. A. Magnus-Levy. 1910. 8vo. 276 pages. J. B. Lippincott Company, Philadelphia and London.


he Johns Hopkins Hospital Bulletins are issued monthly. They are printed by the LORD BALTIMORE PRESS, Baltimore. Subscriptions,


dear (foreign postage, 50 cents), may be addressed to the publishers, THE JOHNS HOPKINS PRESS. BALTIMORE ; single copies will be Fit" mall for twenty-five cents each. Single copies may also be procured from the BALTIMORE NEWS CO., Baltimore.


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BULLETIN


OF


HE JOHNS HOPKINS HOSPITAL


Entered as Second-Class Matter at the Baltimore, Maryland, Postoffice.



BALTIMORE, APRIL, 1911.


[Price, 25 Cents


CONTENTS.


PAGE


PAGE


Notes. (1) Intermittent Fever in Influenza Simulating larial Fever. (2) Grave Malarial Fever with few Parasites the Peripheral Circulation. Dangers of the Intravenous ection of Quinine. (Illustrated.)


y WILLIAM SYDNEY THAYER, M. D. . 101


paration of Antitoxin.


ly E. J. BANZHAF, Ph. D. 106


nical Value of the Determination of the Catalytic Activity the Blood.


ly M. C. WINTERNITZ, M. D. .


109


a Pulmonale in Wisconsin.


ly HENRY HANSON, M. D.


112


Platelets and Megalokaryocytes in Hodgkin's Disease. ustrated.)


y C. H. BUNTING, M. D. .


114


Primary General Peritonitis with Isolation of the Bacillus Lactis Aerogenes in Pure Culture from the Peritoneal Exudate. (Illustrated.) By JOHN W. CHURCHMAN, M. D. 116


The Submucous Resection of the Nasal Septum, Technique and Results in the Writer's Practice. (Illustrated.) By SYLVAN ROSENHEIM, M. D. 121 .


The Growth of Embryonic Chick Tissues in Artificial Media, Agar and Bouillon.


By MARGARET REED LEWIS, M. D., and WARREN H. LEWIS, M. D.


.


136


Proceedings of Societies.


The Johns Hopkins Medical Society


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Employment of Radium as an Aid to Surgery in the Treatment


of Cancer, Angioma and Keloid [DR. LOUIS WICKHAM].


Notes on New Books .


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CLINICAL NOTES .*


NTERMITTENT FEVER IN INFLUENZA SIMULATING MALARIAL FEVER. RAVE MALARIAL FEVER WITH FEW PARASITES IN THE PERIPHERAL CIR- CULATION. DANGERS OF THE INTRAVENOUS INJECTION OF QUININE.


By WILLIAM SYDNEY THAYER, M. D., Associate Physician, The Johns Hopkins Hospital, Baltimore.


r one who has observed much malarial fever is familiar e fact that well-marked paroxysms may occur with ence of very few parasites in the peripheral circulation. is is not uncommon in mild tertian infections. (b) more, it is observed at the onset of mild and even of less serious æstivo-autumnal fever, especially during od of the paroxysm. The cause of this is evident when we remember that the sporulation of the para- ich immediately precedes and accompanies the par- both tertian and æstivo-autumnal fever, occurs, espe- capillaries of certain of the internal organs, particu- the spleen and bone marrow. In most mild cases of tumnal fever, it is rather difficult to find sporulating in the peripheral circulation. (c) The same con- ks made before the Johns Hopkins Hospital Medical Oct. 17, 1909.


dition, i. e., well-marked fever with few or no parasites de- monstrable in the peripheral circulation, is seen in both tertian and æstivo-autumnal infections, but, especially in the latter, where quinine has been given in insufficient doses early in the attack.


In most patients, careful examination of blood reveals para- sites within the twenty hours succeeding the paroxysm, and, even in the absence of parasites, the diagnosis is usually sufficiently clear through the history of the case and the physi- cal appearances, in connection with the condition of the blood which shows usually (1) leucopenia, (2) pigment-bearing leu- cocytes, (3) a relative increase in the large mononuclear leu- cocytes.


Nevertheless, it is well known that there are occasional cases in which, without splenic puncture, a diagnosis can be reached only by the therapeutic test. These cases are not common and,


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in a community where a study of blood is a part of the routine examination, as it is here, where one usually waits for the demonstration of parasites before the administration of qui- nine, it is easy to lay too much stress on the negative results


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of such examinations and to forget that grave and even per- nicious malaria may occur in an individual with so few para- sites in the peripheral circulation as to deceive even the skilled observer on repeated examinations.


On the other hand, however, 'tis very important to remember


that certain other infections may give rise to paroxysms whiz. intrinsically, and in the character of their periodicity, Er closely simulate malaria.


The paroxysms of streptococcus, pneumococcus and =- coccus septicemia are usually distinguishable by the irez- larity, often the great frequency of the paroxysms, and - short duration of the individual access. The paroxysme x- curring in tuberculosis may often suggest malaria, but i: usually readily distinguishable. In the experience of the writer, influenza is the malady which gives rise to those forz. of intermittent fever which most closely. simulate malara. paroxysms. Of the four cases of which we shall speak the evening, two are examples of influenza simulating maara. two are instances of grave malarial fever with a remarkal: paucity of parasites in the peripheral circulation.


CASE I .- Influenza-Tertian Paroxysms Simulating Malaria. T .: first chart, which has already been published in my "Lectures cz the Malarial Fevers," * is that of a woman, E. D., aged 29, who was a patient on Ward " G " of the Johns Hopkins Hospital. T. chart, as you will see, shows a febrile paroxysm beginning te tween 2 and 4 p. m., on the 28th of January and lasting 12 hours This was succeeded on the 30th by a similar paroxysm beginning about two hours later and lasting about the same length of time The patient came from a malarious district and we naturally sa pected a tertian infection. On the first of February, however. there was no rise of temperature and on the 2d and 3rd, sharp elevations occurred, one between 12 and 2 in the morning and the other between 8 and 10 on the following morning. These latter paroxysms, of course, would be sufficient, on examination of the chart alone, to render the diagnosis of malaria improbable.


Now, this patient complained of coryza and cough with a gree. ish purulent expectoration, and showed the signs of a generi' bronchitis. Examination of the blood revealed no malarial or ganisms, and a leucocytosis of 17,000. Influenza bacilli were c. tivated from the sputa and the patient recovered without relapse. and without the administration of quinine.


CASE II .- Influenza-Remittent and Intermittent Fever Simsis. ing Malaria. The second chart is that of a patient whom I saw it February, 1907, with Dr. Friedenwald. As you will see, there is s period of four days of irregular fever, followed by three quotidia: paroxysms, each beginning between 8 and 10 in the morning at. closely simulating paroxysms of a regularly intermittent malaria One might well have fancied that the case represented one of it- fection with mutiple groups of parasites which, under rest in bed had gradually given way until the effects of two strong groups te came clearly evident.


The patient, however, was a boy of about 17 who had been it for about three or four days before the beginning of the chart, complaining of coryza and cough with purulent expectoration and the general symptoms of influenza which was prevalent at the time. From the onset, he had been treated with quinine, gr. Lit (0.2 gm.) every four hours. Well-marked chills continued for nearly a week after the onset of treatment. The blood showed Do malarial parasites.


I saw the patient first on the 14th of February, at which time be showed a general bronchitis. Quinine was omitted and aspirin, ET. v. (0.325 gm.) every four hours ordered. Cultures from the spota showed B. influenza.


The point of special interest in this case would appear to be the sharpness of the paroxysms which were associated with definita


* Thayer, W. S .: Lectures on the Malarial Fevers, New York D. Appleton & Co., 1897.


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CHART III .- MALARIAL FEVER, AESTIVO-AUTUMNAL TERTIAN.


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chills, and the regularity of their onset in the morning hours, as is common in malaria.


CASE III .- Intermittent Fever of the Type of Aestival Tertian. No Parasites Demonstrable in the Peripheral Circulation. Imme- diate Disappearance of Fever under Quinine. The third chart that I would show you presents a rather different appearance. As you will see, there is continued fever on the 19th and 20th of October, the temperature reaching a sub-normal point on the 21st. This is followed by sharp paroxysms on the 22d, 24th, and 26th, the paroxysms beginning in the early morning hours and lasting nearly 24 hours. The chart is typical of aestivo-autumnal tertian fever.


The patient was a medical student of 28. He had been in a malarious district and, two days before admission, had begun to complain of general malaise and on the day preceding admission, of fever. On the day of admission, the 19th of October, he had taken three doses of quinine, how much is not known. On en- trance, the temperature was 102.4º F. at 5 P. M., the pulse 80, respiration 24. There was nothing striking on physical examina- tion of the patient beyond a palpable spleen which extended 3 cm. below the costal margin. The examination of the blood was nega- tive; no parasites and no pigment were seen and the leucocytes were 6400 per cmm.


Oct. 20. The temperature remained elevated. In the afternoon, there was a chill and the temperature rose to 105.8º F .; leucocytes, 4640.


Oct. 21. The temperature fell gradually to 98º F. at noon.


Oct. 22. There was a sharp rise in temperature with a chill at about 6 p. m., the temperature reaching 106.7º F. This was fol- lowed by a rapid fall, and, on Oct. 23, the temperature was normal. , On Oct. 24, the temperature rose slightly in the early morning hours, a sharp paroxysm beginning at 8, with a chill at noon, during which the temperature rose to 105º F. During all these days, the blood was carefully and repeatedly examined in both fresh and stained specimens. Neither parasites nor pigment was to be found and the leucocytes diminished to between 3,000 and 4000 per cmm.




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