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Examination of blood one week after the first appearance of the disease, and at intervals thereafter, did not discover the malarial plasmodium or other para- site. The ha;moglobin percentage was TO. There was a slight increase in the number of leucocytes, and double the usual number of eosinophile cells (noted at first examination only). order arcoxia The urine contained albumin and some hj'aline and granular casts during the acute stage of the disease, which have persisted in diminishing quantity tmtil now. The patient had no renal disease prior to this attack. The above-cited case is a good example of the " wet " variety of beriberi) and fairly represents a large grotip of cases — nearly or quite half of the fifty-eight cases which occurred in 1896 being of this kind. The next case is of similar tj'pe, but terminated fatally before the nervous symptoms reached their full development. It is typical of the so-called " peridcious " form of beriberi. Case II. — "White man, aged thirty-three years, epi- leptic since childhood, very weak-minded and eccentric. He had a mild attack of beriberi in 1895, the nerves buy arcoxia online of the legs Ijeing chiefly affected, and the general arcoxia cost sys- temic disorder of mild character. He recovered entirely in a few weeks and arcoxia price remained well until September, 1896, Nov. arcoxia tablets 2(1, 1897.] BONDURANT: ENDEMIC MULTIPLE NEURITIS. r.87 when he one diiy comiilained of pain, stiU'iiess, and weak- ness in his legs. The second day he was in bed suil'er- buy etoricoxib ing pain in all his limbs and in his body, with numb- Oinrl n Disease. Beriberi. Case No. Vll. Date, Sept. '!)<; ness and tingling in his legs, and some muscular weak- ness. Tendon reflexes absent; heart action rapid — 100 and over; impulse distinct; thrill present. Shortness of breath, etoricoxib 60 mg and much distress and anxiety. Slight cyanosis. Exaggerated pulsation of vessels of the neck. All heart sounds rough and loud, and at the left edge of the sternum over the pulmonary valve a long-drawn blowing diastolic murmur was heard. There was little or no oedema, purchase arcoxia but great tenderness of the calves. The third day the heart action was arcoxia online more rapid (140) and weaker, respira- etoricoxib tablets tion hurried and arcoxia 90mg generic arcoxia panting, and there were dysp- noea, great distress, and restlessness, with " pain all over." A loud, blowing, systolic murmur added to the diastolic murmur audible arcoxia mg the day be- fore. During the day he grew steadily worse, hic- cough set in, and he died seventy hours after the onset of the first symptoms, of heart failure and asphyxia. He had no fever and no gastric disorder. Treatment consisted of laxatives in the begin- ning, with heart stimulants and small doses opium. same area, and at the same time an increase in rapidity of heart action was noted. buy cheap arcoxia At the height of the disease, a fortnight after its onset, etoricoxib msd the nerve symptoms were: Almost complete paralysis of buy arcoxia the muscles of the legs, with marked foot-drop; partial paralysis of the muscles of the purchase arcoxia online thighs, body, and upper extremi- ties; hand grasp almost nil; wrist-drop marked; all muscles relaxed and flabby. All tendon re- etoricoxib arcoxia flexes abolished; plantar reflex abolished; pain " almost all over " of an aching, distressing char- acter, worse at night; great tenderness of muscles; partial anssthesia of the skin of the legs, loss of acuteness of tactile feeling; delay in transmission of order arcoxia online painful impressions. The patient's constant complaint was that her "legs felt dead." The pain subsided after three wrecks, but tenderness on pressure persisted for several weeks longer. The oedema was general, but not excessive, and subsided after two weeks. The heart action re- mained rapid for six weeks, and during a portion of this time there was a distinct blowing systolic murmur at the apex and along the sternum. The ves- sels of the neck throbbed violently, and the pulse at wrist was soft and weak. The gastro-intestinal symp- CUiiH III Disease , Ben

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