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Scientific Proceedings (121). 



plenty of plain water. Stimulants and warmth should be ad- 

 ministered to avoid collapse. Diuretics and an abundance of 

 liquid should be given to combat nephritic conditions, and alkalies 

 should be administered to prevent the tendency toward acidosis. 



I purpose to present to you to-night a case that came for 

 treatment on the Third Medical Division of Bellevue Hospital, 

 under the direction of Dr. S. A. Brown. This case is of interest 

 because the patient recovered, although antidotal treatment was 

 delayed, and also because of the complete blood study throughout 

 the patient's stay in the hospital. 



J. M., a building superintendent, age 44. 



Present History. — The patient had no bowel movement for 

 2 days and decided to take what he thought to be a dose of epsom 

 salts. He immediately noticed a peculiar sour taste, with a 

 burning sensation along the esophageal tract, followed presently 

 by severe pains in the epigastrium, which gradually increased. 

 An ambulance was summoned and when the surgeon attempted to 

 examine the patient's throat he vomited. The surgeon, diagnosing 

 it as a case of indigestion, administered sedatives and left. Shortly 

 thereafter the patient developed pain in the lumbar region, the 

 ambulance was summoned again and he was taken to the hospital 

 on October 1, 192 1, at 4:30 A.M. 



In the course of the succeeding hours he complained of burning 

 pains in the stomach, first localized, then radiating through the 

 abdomen, and of pain and tenderness in the lumbar region. 

 The next morning, after taking a glass of milk, he again vomited. 



On physical examination, he was found to be well developed 

 and well nourished. The pupils were equal and regular, reacting 

 readily to light and accommodation. The tongue was clean, the 

 teeth poor, the throat congested. There were no adventitious 

 sounds in the lungs. The heart sounds were of fair quality, no 

 murmurs, rhythm regular, rate 90. The abdomen showed no 

 rigidity, no masses, no tenderness. The spleen was palpable just 

 below the costal margin. The liver edge was also palpable. On 

 deep pressure in the epigastrium, there was pain. There was no 

 edema. Reflexes — no Babinski, no clonus, abdominal cremasteric 

 and knee jerk active. 



Treatment consisted of fluid diet, with hot packs, colon irriga- 



