82 Frederick Mott 



about November I4th and began to fade and became scaly on the surface 

 by the igth and 20th. 



He was seen on the lóth and on that day blood was taken which 

 showed slight leucocytosis, and a blood culture which proved sterile. A 

 film from a septic sore showed a mixture of niany bacteria, staphylococ 

 cus, short chain streptococcus, and diptheroids. 



He was lumbar punctured on the l8th, and about 20 c. c. clear fluid 

 with drawn. Sterile on culture on serum agar plates. No protein or 

 leucocytosis. The sample examined contained a small amount of blood. 

 He first vomited on the l8th and about 5 times on the iQth-bile stai- 

 ned fluid. He ceased to be able to swallow towards the evening of the 

 iQth. Some tendency to head retraction was developing. He was placed 

 on glucose saline rectal injections and absorbed over a litre of this dur- 

 ing the night 20th-2lst. He was also given lO c. c. antistreptococcal 

 serum. 



During the night of the 20th-2lst his pulse became imperceptible at 

 the wrist, and his respirations rose to over 40. I am indebted to Dr. Pe- 

 trie for the clinical notes of this case. 



Tke Post Mortem Examination was made the next day after death 

 and beyond congestive hyperaeaemia of the brain and its membranes, 

 nothing noteworthy was found to account for death. Careful examina- 

 tion of all the organs was made, and microscopio examination also; here 

 again nothing was found to account for death, except congestión of the 

 vessels, throughout the brain, and minute haemorrhages, especially were 

 these observable in the medulla oblongata. No where coul(i any evidence 

 of micro-organisms or inflammatory reaction be seen. There was conges- 

 tión of the vessels in the portal system but not more marked than one 

 might expect from heart failure. The valves of the heart were normal 

 and the muscle shewed no marked change sufficient to account for its 

 rapid action. No marked change was observable in the thyroid or su- 

 prarenal glands. The only organs, besides the brain, which did show a 

 notable change were the testes which weighed when freed from túnica 

 albugínea and epididymis, only 8 grammes each, which is less than half 

 the normal weight. They presented a uniformly grey instead of a white 

 appearance quite like the organ in advanced cases of dementia praecox. 

 Strange to say the microscopio appearances are exactly the same as the 

 testes of the brother who died in a London Hospital from a bullet wound 



