bumen disappeared, and
she became well enough to walk and drive; when a sudden congestion of
the kidneys destroyed her in forty-eight hours.

The following case of extreme anaemia, with striking resemblance to the
pernicious type in some of its features, is especially interesting for
the ease and rapidity of improvement under rest and massage without
electricity or excessive amounts of food.

Mrs. T., aet. 40, the mother of several children, had been unwell for
years, and almost totally incapacitated for exertion for two years
before admission, in January, 1894. She complained of extreme
feebleness, distaste for and inability to digest food, a great and
constant difficulty in swallowing, shortness of breath, dropsy of the
ankles if she walked or stood, hemorrhoids from which some bleeding
often occurred, extreme constipation, constant chilliness, and frequent
violent headaches. Her appearance was that of a person with pernicious
anaemia, a very yellow muddy skin, dry and harsh to the touch, and the
hands and feet cold, almost to the point of pain.

On examination the spleen was decidedly large; the lower border of the
stomach reached to the level of the umbilicus. Two cardiac murmurs were
present, the one a sharp and well-defined mitral regurgitant sound,
confirmed by the dyspnoea and dropsy as organic, the other a loud
musical murmur of haemic origin. The trouble in deglutition proved to be
due to an oesophageal narrowing. The blood examination bore out the
suggestion of probable pernicious anaemia, the red cells being only
1,500,000, haemoglobin 18 per cent.: the microscope showed microcytes,
megaloblasts, nucleated red cells, and a large increase in white
corpuscles. In order to study the effect of massage alone upon the blood
no other treatment was used, though of course the patient was kept at
"absolute rest." No drugs were given, electricity was not used, and
extra food was omitted, as the irritability of the oesophagus made her
unwilling to attempt the exertion and annoyance of frequent feeding. The
general chilliness was at once helped by massage, and in a few days only
felt in the small hours of the night, and the patient gained weight from
the first. After one week of treatment a blood count was made: red cells
were 3,800,000, more than double the former figure; haemoglobin, 35 per
cent., almost double its original value. On the same day, one hour after
the completion of an hour's massage, the corpuscular co