HYPERTHYROIDISM WITH ORAL SEPSIS 125 
was not upheld in this diagnosis by any other member 
of the staff, except possibly the surgeon who had put 
me in charge of the case, who went so far as to say the 
heart condition was not dependent on the wound, 
though the thrombus was. 
Diagnoses varied. The officer in charge of the hos- 
pital diagnosed “cardiac trouble but did not think of 
thyroid.” One surgeon “did not think it was a thyroid 
case.” The senior surgeon and the heart specialist 
both diagnosed ‘‘septic myocarditis; but did not think 
it was due to the thyroid.” 
Jan. 1, 1916—Patient was carried, bed and all, to the 
X-ray room, as he was too weak to transfer to a 
stretcher, and given a full filtered pastille dose of X- 
rays to each lobe of the thyroid. P., 158 (lying down). 
At the same time a vigorous effort was made to clear up 
the oral sepsis by wiping round the gums frequently 
with strong tincture of iodine. 
Jan. 3—Pulse distinctly better, 112. Tinc. iodine 
continued. 
Jan. 7—Second dose of X-rays, looks brighter, edema 
now reaches to left mid-calf, tubes out of wound. P., 
120, slightly irregular; perspiration very marked, 
mouth cleaner. 
Jan. 14—Fortunately, an abscess in the left buttock 
required opening under general anesthesia. The bone 
was scraped and, at the same time, several septic dental 
stumps were removed. In spite of his very weak condi- 
tion the patient took open ether well, the pulse being 
136 at the beginning and only 120 at the end of the 
anesthetic. 
Jan. 26—Third X-ray; and from that time on X-rays 
were given at about weekly intervals till the end of 
April, finally ending May 27, 1916, with the 17th treat- 
ment. 
