420 CASES or ex(.phtiialmic goithe. 



June 30. Urine, 4 piuts ; ep. gr. 1027, alk. Temp., 99". Xo diarrlicea? 



appetite good ; sleeps well ; loss- 

 oedema of feet; seems better- 

 Ordered — Acid, ritrohjdroclilor.. 

 dil., riX X, ; liq. strychnia?, tr^ iii-r 

 tinct. opii, U^ v. ; aq. mentli. pip „ 

 5 i., tor die. 



July 3. „ .. „ 1013. 



7. J, 4} pints ; „ 1013. General condition improved; sugar 



ratlier diminished ; feet still a* 

 little swollen. Ordered — Hst.. 

 soda? cit. efl'erv. Gtis horis. 

 „ 13. „ 3} „ „ 1033. 



16. Ordered — Liq. strychniae, ni iii. ; tinct. opii, Ul v. ; acid pbospli.. 



dil., nt XXV, ; aquae, % ii. Gtis lioris. 

 28. Urine, 5 pints; sp. gr. 1028. Katlicr hysterical. Weight, 5st. SIbs.. 



Urine. Percent jge Total nrea.. 



c.c. Sp. gr. Reaction. of urea. Grammes. 



August 23 .. 2565 lU3 ) Acid. '73 18-7245 



° 27 .. 2280 3030 Acid. '85 18-96 



"^ 2i ., 2700 1025 Faintly acid. -825 22*275 



September 1. — Urine, 4 pints, sp. gr. 1030. ]N"otliing ab- 

 normal in funduij of eyes. 



September 8.— Gained 3-Jlbs. during the last few weeks. 



September 23. — Not quite so well last night. 



October 4. — Had not been quite so well during the da}v 

 Hysterical, and crying a great deal. About seven o'clock she- 

 went to bed, and took some beef-tea ; about nine she spoke to- 

 the nurse ; at 10 the sister saw that she was lying quiet, with 

 the curtains of the bed slightly drawn ; and at 11 p.m. she was 

 found to be dead. No dyspnoea whatever was observed. The= 

 friends of the patient would not allow^ a post-mortem examina- 

 tion in the hospital, and after some difficulty permission was. 

 obtained to examine the body at their house. Owing to tho: 

 circumstances under which it was made it was exceedingly 

 imperfect and unsatisfactory. The lungs were much con- 

 gested and oedematous. There was no consolidation, and thev 

 were singularly free from pleuritic adhesions. No vegetations- 

 were observed on the cardiac valves. The left ventricle was 

 contracted and empty; the right ventricle contained a little- 

 blood. The liver was normal. The thyroid gland was enlarged 



