Two Cases of Sub-Acute Hepatic Necrosis.

Case 1.A girl baby, aged 8 months, was brought to the East Londoni Hospital for Children with the complaints that the abdomen had beeni swelling and that the ehild was occasionally yellow. She had had broncho-pneumonia, not severely, six weeks previously, and before that had been perfectly well. She was the first child of a young couple, aged 20 and 21 respectively, both healthy. There had beeni ino miscarriages; she was born at full term and weighed 94 lb. at birth, was beinig breast-fed entirely and had gainied weight steadily until her illniess. Oii admission the child was fouind to be w%iell developed and well niourished, weighing 15 lb. 12 oz. She looked very pale with a sub-icteric tinge, though with ino icterus of the selerae. No teeth. No sign of rickets in epiphyses. Chest normal. The abdomen was protuberant, with some enlarged veinis in the wall, runining from groin to thorax. The liver was much enlarged, the edge being below the umbilicus it was hard and firm, no nodules could be felt and it was evidently not tender. The spleen was also enlarged, firm and smooth; its tip was at the level of the umbilicus. Urine: no albumin, sugar, pus or bile; not tested for urobilin. Blood: red blood corpuscles 2,390,000 per c.cm., haemoglobin 48 per cent., white blood corpuscles 20,000, fragility of red cells normal. Mantoux reaction negative. Wassermann reactions were tried oIn more than one occasion, anid Kahn once. They gave the followiing results:-