On October 2 the skin over the chest and abdomen Ijecame 

 reddened and hot. A chill and left pleuris}^ developed. Para- 

 centesis produced about 600 cubic centimeters of straw-colored fluid 

 on October 8. Skin scarlet all over body. All this time the urine 

 remained thick and liloody, but on October 10 became normal and 

 has remained so. The temperature throughout, except during the 

 attack of pleurisy, remained about normal — 97° to 99.4° F. in the 

 morning and 9S° to 99.4° F. in the evening. 



Until the pleuritic attack the patient had gained 25 per cent in 

 weight and general appearance, and, although an evening tempera- 

 ture of 1° to 3° F. persisted until October 22, she regained strength 

 so rapidly that on October 29 and 30 the X-ray was again applied 

 for fifteen minutes, after quinine, with the bulb 5 inches away. 



Although the patient has been at home and walking about for 

 the past two months, her chyluria has not returned. The living 

 embryos still persist in her blood, and hence it is altogether likely 

 that the treatment had no effect upon the adult parasites. 



SPECIAL FEATURES OF THE CASE. 



(1) Tlie urine. — The analyses of the urine have yielded the usual 

 findings in such cases, excepting our failure to extract fatty matters 

 in appreciable quantities. The bloody, milky urine never altered 

 its appearance on prolonged shaking with ether, even after making 

 it alkaline with sodium hydroxide, and the evaporation residue 

 seemed to consist of other than fatty extractives, though in one 

 instance a trace of fat was found by testing for glycerine. Its 

 milky appearance may have been partly due to the considerable 

 number of leucocytes it contained. The amount of all)umin varied 

 l)etween 0.33 and 0.6 per cent. For example, an analysis by 

 Mr. C. L. Bliss, physiological chemist of the Bureau, on August 26, 

 gave: Quantity, 675 cubic centimeters; specific gravity, 1,026; 

 reaction acid l)ut turning, kept at 30°; all)umin, 0.83 per cent, 

 average of five tests by Esbach's method ; fat, trace, by glycerine test. 



(2) The blood. — Four days after admission a blood count gave 

 3, 100,000 reds and 6,000 whites. The anjcmia almost disappeared 

 as the general condition of the patient improved, during the period 

 when she was at rest with the hips elevated. The excessive loss of 

 blood did not continue for a long time and the anaemia did not 

 reach the grave character of such cases as Herrick (1) described as 

 due to repeated losses of blood from hemorrhoids. 



