Calendar: 1891-1892 Page 849

MEDICAL DEPARTMENT Clxi What are the symptoms and physical signs of acute bronchitis in child and how should the case be managed lve an outline of the case of patient now in the Craven Ward with enlarged liver and dilated abdominal veins What is your opinion of the nature of the case Give list of diurectic remedies State the cases in which they vould be useful and write four prescriptions for diuretic mixtures II -Cast in jilctiiane for Commentary very strong thick-set over-worked plethoric anxious man nearly forty years of age and weighing perhaps two hundred pounds seems to have suffered from 11 chill which was followed in day or two by feverishness and pains in the limbs The joints however were not affected The skin was at first dry then moist and occasionally there was free perspiration In about week from the commencement of the attack slight pericardial rub was detected but it dis- appeared in few days The temperature which from the first had ranged between 100 and 103 was found one morning to have risen to 108 the patient having been weaker and delirious during the night By treatment the temperature was soon reduced to 102 and it remained near this point for seven or eight days and the patient's general condition had improved but another sudden rise to 108 unexpectedly occurred and was followed in few hours by death Comment on the case and endeavour to account for the facts giving description of the probable pathological changes Discuss the probable effects upon the ordinary physiological chinges in the organism of temperature ranging from 101 to 105 or higher and extending over period of month especially with regard to convalescence and the reparative processes after long illness Enter fully into the question of the general management and medical treatment of such case as the above