Medical Members' Monthly Meeting

Abstract

A Meeting of the Medical Members was held in the Reid-Knox Hall of the Institute on March 17, 1939. Dr. J. F. Brailsford was in the Chair, and about 40 members were present. The following cases were discussed: Dr. Barrington Prowse: A case for diagnosis. ? Brill's disease. The patient, a woman of 72 years, developed a slight cough about nine months previously. In December of last year she was debilitated, complained of indigestion, and an increase of the cough. She was rather pale, and had dyspnoea on exertion. Dullness and other signs of fluid at the right base of the right lung were found. Except for a slight leucopenia there were no significant changes in the blood. The radiograph of the chest showed a right pleural effusion and an apparent pericardial effusion. The electrocardiogram was normal. Ten ounces of pleural fluid were aspirated, and the exudate showed a deposit of leucocytes (98 per cent, lymphocytes) and erythrocytes. The organisms were cultured, and tubercle bacilli were excluded after inoculation of a guinea-pig. In February 1939, forty-five ounces of pleural fluid were aspirated, but no organisms were isolated. The radiograph, taken at that time, threw doubt on the existence of the pericardial effusion. There was then the appearance of a solid tumour displacing and rotating the heart towards the right. During screen examination, apical pulsation was visible below and to the right of the tumour.