A Case of Universal Dermatitis: Probably a Rare Variety of Mycosis Fungoides
Authors: M. Morris
Journal: BMJ (1894)

ITNIV\ERSAL )ERAIATITIS.[Tin B&i, 1181 viously observed lhad grown worse, and I learnt that lhe hiad been subject to attacks of broniclitis duriing the winter months.As regards hiis mental condition Ino improvement was observed.His expression was as dull as before, hie used thle sameX childislh words, hiis vocabulary not appearing to have increased, and lhis voice was as guttural as ever.For a week after admission lie was merely kept under ob- servation, and hlis temperature was regularly taken.'This was found to be mostly subnormal.The treatmenit was then com- lmenced by the administration of 36 grainis of raw thyroid gland.The temperature rose slowly until, at the end of twenty-four hours after the dose, it stood at 102.4°, and for the next four days it fluctuated between 100°in the morning, and 1020 at night.In addition to hiis feverisliness lie fell off hlis food, vomited once, was restless at night, heavy and morose during the day.The temperature then fell to normal.In these four days hle lost 2 lbs. in weighlt.He subsequently took four similar doses of the raw tlhyroid at intervals of several days, but after none of tlhese later administrations was the effect anything like that of the first, the highest temperature being about 1000.He continued, however, to lose flesh, though more slowly than before, and, after having taken four doses of the gland, he weighed 32 lbs.On May 17th he began to take daily two of the thyroid tab- loids of 5 grains eaclh manufactured by Mlessrs.Burroughls and Wellcome, and since then this dose has been gradually increased until at the present time he is taking five tabloids daily.The treatment has been followed by a manifest im- provement, both physical and mental, and this result las been obtained without any injurious effects being shown.The temperature has rarely exceeded 1000; for the last month it has been usually about 990.To enable the reader to glance shortly over the symptoms of his progress as they were observed I will give extracts from the notes taken at the bedside.May 11th.His hands are moist, his tongue is not so pro- minent, his face is less puffy, and his complexion is losing its earthly hue.May 29th.His lips are thinner, the lower lip especially; the tongue seems narrower, and he often lias his mouth closed.He is much more lively-in fact, lie can hardly be kept covered by the bedclothes, although efforts are con- stantly being made to keep him quiet.June 11th.He has gained an inch in height, and hias lost 5* lbs. in weight.His abdomen is flatter than it was.July 4th.He was heard telling the patient in the adjoining bed to " lie down," but' his voice is still guttural.On July 17th he was sent home for a time, his parents being instructed to give him two thyroid tabloids daily.On November 1st he was readmitted, suffering considerably from bronchitis.He measured 35 inches in height and weighed 311 lbs.He continued to take two tabloids as be- fore, and ani estimation of the amount of urea passed by him was commenced.In November the daily average was found to be 182 grains, in December 208 grains, in January 180 grains, in February 165 grains, and in M1arch, to the time of writing, 175 grains.On November 9tlh the number of tab- loids given daily was increased to three, on the 24th to four, and on February 19th to five.These doses, as I have already said, have not caused him the slightest inconvenience.