seened. to feel very pleasant and said that he might be able to go hons
sonetine this fall; he asked me to come and visit him at his home, How

evor, on 21 August the yellow pigmentation of the ocular conjunctiva
increased somewhat and the patient lost his appetite. The color of
urine grew deeper after 26 August. On 27 August the Meulengracht index

was 105,

From ebout 1100 hours on 29 August the patient's consclous-

ness was hagy and he seemed to be in a state of exciteront.

On 31

August, he lapsed into coma. On 3 September, he appearod to have re~
gained consciousness, and on the morning of 4 September he uttered a
few words, His bahavior showed signs of Korsakofff's syndrone from
that tims util 8 Scptenber. He almost recovered full consciousness

on 9 September and was placed on a liquid diet.

The Meulengracht

index was 225 on 2 Septexber and it continued as high as 140, or

sometinos 160, after that. The patient's appetite was comparatively
good; but edema waa observed on 6 Septe-bor and it wes presuzed to be

an ascitic accuculation,

After 17 September the patient lost his

appetite end ate nothing after 20 Sopicuber.

Fron that time his blood

Pressure dropped, his pulse rate increased, and ho developed syxptons
of so-called heart prostration. Tha potient died on 23 Septexber.

This was in outlire the progress of tho discase.

Let me give you som edditional data. Figure 38 in the monograph
shows photomicrographs of the tissue patterns in the marrow taken when
the patient was first hospitalized on 2 April. According to this fig~
ure the nuzber of cells 1s very sall, showing hematopoietic dysfune~
tion, After tha patient emerged from coma in Septenber, the white cell
count increased to 10,000 and 20,000, Leutomla was obsorved in the
peripheral blood pictura. In an x-ray plate of tho chest teken on 17
Sentenber we discovered a shadow the size of a thumb in the lower part
of the upper left lobe. In an x-ray plate taken on 22 September we
discovered a shadow of tha same size of a fist in the upper right lobe,
indicating peunonia,
I am following the wrong order, but let me read you Mr. Shimatanits
opinions on the electrocardiogram of Hr,
.

Bight after the hespitalization: at the induction of the licbs, the
P wave shored only extrensly flat, low traces, At right precordial

induction the § and T rose slightly and the P (+~) showed diphase;

at left precordial induction, the 3 and T ware slightly lowered.

The aforementioned finding, regardless of causes, indicated sons

myocardiac dysfunction. But the P wave gradually rose and the findings
of 10 August showed a picture which was nearly normal.
According to the findings of 31 August, at tha second and third induction; of the linbs, and at the inductions of aVF and V., the S ani
T wore lowsred; every induction showed a completely flat
wave.

This indicated damage to the entire myocardium. ~‘ccording to the EXG
findings on 6 end & Septenber, the 3 and T were lowrcd amd the T wave

was flat and low, showing the tendency to gracual aggravation of the
pationt's condition. According to the findings of 18 Septenber, all

dinduction voltages were prominently decreased,

The EXG of 21 Septetber showed extreme aggravation ant complex
arrhythaia accompanying dysfunction of the atria end ventricles. The

US DIF ARSAI VES

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