Case of Malignant Jaundice occurring during the course of Graves' Disease and associated with Gangrenous Tonsils.' By J. P. CANDLER.THE folloWing case, whichl I have termed acute biliary toxaemia, is, I think, worthy of record both on account of its own particular interest and because of its close resemblance, in many of the clinical and pathological features, to that variety of acute degeneration of the liver found in phosphorus poisoning and in the rare disease known as acute yellow atrophy.The patient, a female, aged 38, single, and previously a housekeeper, was admitted into the London County Asylum at Claybury in Septeinber, 1901. She had been twice previously in this institution. She is described as suffering from recurrent melancholia. She was depressed, had suicidal tendencies, and was under the delusion that she was being followed about by people and that a gallows had been prepared for her because she had been the cause of the explosions in London. She also believed that her food was being poisoned; she complained at times that her head was bad. The thoracic and abdominal organs were normal, the tongue clean, and the teeth in good condition. There was no history or evidence of venereal disease. She was released from the asylum in March, 1904, but was readmitted after a month owing to a relapse; she continued in fair health until Februarv, 1907. In September, 1907, she first exhibited symptoms of Graves' disease (exophthalmos, enlargement of the thyroid, irregular heart's action with tachycardia and tremors).
