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. Tine, 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. 



