Calendar: 1880-1881 Page 707

MEDICAL DEPARTMENT 707 acute symptoms passed off in fortnight but the patient remained weak and there was evidence of some degree of emphysema The heart's action continued weak The pulse was almost always above 100 The respirations were quick irregular and shallow There was decided pain in the upper part of the dorsal region of the spine The patient could however take deep breath The temperature was usually between 99 and 101 but occasionally rose three or four degrees higher On trying to walk after his bronchitis had passed off he discovered that his legs were weak and in short time it was noticed that the bladder did not thoroughly empty itself The urine from being clear gradually became more and more opa- lescent until at length decided deposit formed after standing-and in every specimen of urine passed Some- times the urine was ammoniacal and then the character of the deposit was changed trace of albumen was found from the time when the deposit commenced to form The bowels were constipated The paralysis of the legs steadily increased and it was necessary to draw off the water regularly The patient got weaker and died about four months after his admission-no improvement having occurred in the symptoms after the first fortnight Comment on this case and give full description of the morbid changes you would expect to find State what you know of arm presentations the diffi- culties apt to arise in connection with them the mode in which these difficulties are occasionally naturally overcome and describe the treatment you would adopt under various circumstances Describe the various operative procedures that may be γ γ