Page:Transactions of the Royal Society of Tropical Medicine and Hygiene, volume 1.djvu/159

 dent had just narrated were almost a picture of those which his own case presented. The patient was a high-caste Hindoo, a native of the Behars, who had suffered from fever for about two years and six months. He had been under almost every form of treatment, including the Vedic system and the Western system, and there were very few drugs that had not been tried. He had been heroically treated by large doses of quinine, which had been given jper rectum, by mouth, and hypodermically ; he had had arsenic and iron and methylene blue ; in short, he went through the whole materia medica ; to say that was the easiest way to enumerate the drugs the unfortunate man had received. When he saw the patient, the spleen-dulness came down to the navel ; the liver was a hand's breadth below the costal arch ; the digestion was extremely bad ; the tongue was at one time clean, and at other times foul ; there was occasional vomiting, and profuse attacks of haemorrhage, the latter of which very frequently brought him to the verge of the grave. Night sweats were very profuse, and weakness was intense, though at times his appetite was fairly good. It should be stated that the case had been diagnosed simply from the clinical symptoms, and not from an examination of the blood. The peripheral blood was examined, but it was impossible to make either a splenic puncture, a hepatic puncture, or a puncture of any kind; in fact, the services of the doctor who was in charge of the patient before he (Sir Havelock) was called in were dispensed with at a few hours' notice because he made such a suggestion. No malarial organisms wei'e found in the peripheral blood, and an element of interest was one on which Dr. Bassett-Smith had touched, that it had been diagnosed as a case of Mediterranean fever. The patient was cured by fresh air at sea ; he spent four months at sea, voyaging between Colombo and Australia, changing from one boat to another. He simply had the ordinary tonic