The word "polyuria" as used in this article means excessive urination following or accompanying excessive intake of water by mouth, a "urina potus" in which the constituents of the urine remain in normal proportion to each other, but in which the urine is extremely dilute. REPORT OF A CASEHistory.\p=m-\JamesG., aged 7\m=1/2\years, had been under my supervision from the age of 18 months to 5 years, at which time the family moved east. There was nothing unusual in his early history, except a mild facial eczema. I next saw him on May 8, 1931, when he was brought back for examination because of the following complaint: On Sept. 9, 1930, he was vaccinated on the arm with a glycerinated vaccine virus1 by the multiple puncture method. He had never previously been vaccinated. The third day after vaccination he had a temperature of 102 F., and a pustule developed at the site of the vaccination. The temperature returned to normal in twenty-four hours, and the child appeared well. His brother was vaccinated at the same time, but no "take" occurred. On the seventh day after vaccination the patient complained of headache and had a fever. The temperature was not taken. He had severe chills which shook the bed that night and every night for the following month, and an enormous thirst immediately developed, the child rising as many as twelve times a night to drink and urinate, drinking as much as 12 ounces (354.8 cc.) and urinating up to 18 ounces (432.3 cc.) at a time. A marked change in behavior took place; the boy, who formerly was an even-tempered, agreeable child, became difficult to manage, and showed pronounced emotional instability.The temperature subsided in twenty-four hours, but the thirst, frequency of urination, chills and irritability continued unabated for a month, when the chills diminished in frequency ; they have continued to do so up to the time of writing, though he still wakes occasionally and complains of being cold. His average twenty-four hour intake of water during the first month of illness was 220 ounces (6,505.4 cc), and the urinary output was 185 ounces (5,470.5 cc.) (figures given by the family).One cubic centimeter of solution of pituitary was given hypodermically three times a day in September, 1930, with no perceptible change in the intake of fluid or the output of urine.Examination.-When brought to me on May 6, 1931, the boy weighed 51 pounds (23.1 Kg.) and was A7l/2 inches (120.65 cm.) tall. Physical examination 1. Manufactured
Acute osteomyelitis of the superior maxilla in infants is sufficiently uncommon to merit reporting, and, with the exception of the picture accompanying a case report by Bass, it has no pictorial record known to me. This disease is so typical in its signs, as illustrated in the accompanying photographs, that it should not fail to be recognized. REPORT OF A CASEJohn W., aged 5 months, the first child of healthy parents, was suddenly seized with apparent acute abdominal distress on Dec. 31, 1929. He had had no history of previous illnesses or of injuries. The temperature was 100.2 F. Physical examination failed to reveal the disorder. The infant was restless all night, and on January 1 the temperature was 101 F. There had been no stool for the previous twenty-four hours, and clear water only was returned from enemas. No mass could be felt in the abdomen. Urinalysis gave negative results. Small amounts of formula were taken without vomiting. On January 2 the temperature had reached 103 F.; the infant was restless, and had had no movements of the bowels.The blood count showed : white blood cells, 17,500, and polymorphonuclears, 75 per cent. The infant held the right thigh partially flexed and resisted palpation of the lower part of the abdomen. Consultation was requested, and the infant was examined by a fellow pediatrician and by a surgeon. Roentgen examination of the chest did not give any assistance, and it was concluded that a condition of the abdomen necessitating surgical intervention was present. The infant was taken to the hospital for an exploratory laparotomy. At operation the abdominal contents appeared normal, except for a few enlarged glands at the base of the appendix. The appendix was removed, the abdomen closed, and the infant returned to his room in good condition.Two hours after the operation the attending nurse called me because of marked swelling of the right eyelids. The palpebrai and ocular conjunctivae showed no congestion. This was the last look at the eyeball that I had for many days, as the edema of the lids progressed with great rapidity to such an extent that the palpebrai fissure was completely and firmly closed. The following day the right cheek was greatly swollen and hard. Examination of the mouth revealed over the right lateral incisor of the right maxilla a sinus the size of a pinpoint, which was draining pus. Both sides of the nose were completely occluded by the swelling.On the second day after the operation, the posterior portion of the alveolar process of the right maxilla appeared gray and tense, and it was incised. No pus appeared at the time, but in a few hours it began to drain through the incision. On January 6, the seventh day of the illness, a second sinus appeared, half an inch to the right of the original sinus. This drained freely. The swelling of the lower eyelid appeared fluctuant ; it was incised, and drained a large quantity
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