Calendar: 1893-1894 Page 871

faculty OF medicine IV a$z in urgtri for Commtntarj Discuss the diagnosis and treatment of the following case Λ Έ aged 10 male admitted Aug 14th Had measles when 10 mouths old Since he was 18 months old has suffered periodically from trouble in his right ear Each attack commenced with earache followed in day or two by purulent discharge after which the pain ceased The dura- tion of the intervals between the attacks rarely exceeded months Polypi have been removed from the ear On August 7th one of these attacks commenced and the ear and surrounding parts became painful and swollen Aug 9th The pain in and about the ear increased and pain in the top of the head discharge from ear sick in the afternoon became dull and lost appetite -Aug 11th Pain and swelling increased and slight rigor -Aug 14th Rigor in the morning 102 patient semi-conscious takes no interest in his surroundings tenderness and redness on the mastoid process and at one ear both of the discs swollen right more so than left -Aug 15 Rigor during night 103 rigor in afternoon 102 membrana tympani practically absent Avail of tympanum carious no obstacle to free escape of pus mastoid process painful on pressure no fulness or tenderness in the course of the internal jugular vein patient semi-conscious Carbolic acid- What arc the symptoms produced by poisonous dose of this substance What treatment would you adopt in such case What post-mortem appearances would you expect to find iS ΙΓΙ What conditions may be simulated by profound in- toxication Give the symptoms which would guide you in diagnosis