Asthma and a lump in the breast.

because corticosteroid treatment has, for some reason, been omitted, or because the dose has not been sufficiently increased during an intercurrent illness. It can also arise during an attempted withdrawal of glucocorticoid therapy. The clinical features are those of glucocorticoid deficiency, and treatment is with high doses of cortisol, which usually have to be given parenterally. would you have a look at Mrs. C.D. I can't make her out, I have been treating her for five or six weeks for a spasmodic cough and I think she is developing asthma. J.W.S.: How old is she, Charles? C.H.G.: Forty-two. You will see from the thinness of her record card she has rarely seen us. She had one child about 14 years ago, but that was stillborn. J.W.S.: It is a bit unusual to develop asthma this late in life. Are there any precipitating factors? C.H.G.: What do you mean? J.W.S.: Infection, allergy, any stress in the family. Is she a worrying type of person? C.H.G.: No, she is rather a neat, tidy, good looking woman with a very good husband. By the way, I have asked sister to do some routine tests. can find very little wrong here and confirm all your findings. There must be an allergic factor. She tells me she acquired a budgerigar in December. I have asked sister to do Bencard skin testing. 21 February: Skin tests; all negative except feathers. In view of the above I suggest specific desensitization-J. don't really think that is the answer. She is now producing yellow sputum and I have put her on tetracycline for two weeks, and she seems a great deal better. Very well, but all these investigations are a bit beyond me. I'm rather old-fashioned. Actually, a mass radiography survey was done in November on her and that was negative. Entries on Medical Record Card E.C.8 23 March: X-ray chest: no gross pulmonary lesion. Slight increase in hilar shadow and some peribronchial opacity. E.C.G.: normal except for increase in QRS complex in lead 2. (4 7uly) Would you be good enough to pop in and see Mrs. C.D. She has had some kind of asthma for the past five months, and I was called out once again at 10 p.m. Last night she was wheezing terribly when I got there and the whole family were in a state of excitement. I noticed that as I sat down and …