1914 Journal of the American Medical Association  
eosinophils and basophils, 1 per cent, of each. Two Wasser¬ manns taken one week apart were negative. Urinalysis : Examination was made particularly for indi¬ can, and the reaction (Obermayer's method) showed it to be present in great quantity. There were no albumin or casts, and no sugar. Unfortunately gastric analysis was not done until the disease had begun to improve under treatment. Ewald's test meal was given and removed in an hour. The quantity was about 25 c.c. Free hydrochloric acid
more » ... Total acidity 61. Occult blood ++. No lactic acid was present. No tests for ferments was made. Subsequent History.-The case has attracted a great deal of attention and has been seen and examined by many physi¬ cians of St. Paul and Minneapolis and by other medical men, prominent in the Northwest. At no time has the diagnosis been seriously questioned. The triad of cutaneous, gastro¬ intestinal and nervous symptoms are plainly evident, even on cursory examination. The patient has now been in the hospital and under con¬ stant observation for a period of over seven weeks. During this time he has received a nourishing diet, and all forms of exertion have been interdicted. Medicinally he has received Fowler's solution, begining with 5 drops, and increasing to 20, three times a day. In his general condition marked improvement has occurred. The skin symptoms have ameliorated ; in fact, the facial eruption has almost entirely disappeared, leaving a surface of peculiar dark-red color. His mental state has also improved. At first he paid little heed to his surroundings unless solicited to do so, and was inclined to resent attention of any sort. He has now become more communicative and cheerful, takes an interest in all proceedings affecting him and is an exceedingly well-behaved person. His present attitude is one of distinct euphoria, and he is subject to outbursts of senseless laughter. He still complains of insomnia, but his former intense cephalalgia has receded. At first scarcely able to move about, he now assists in the general work around the ward. Certainly all has been accomplished that could be expected of any line of treatment in so short a time.
doi:10.1001/jama.1914.02570140013006 fatcat:6j225ifyujb7nf6hdstuvfdkeu