A Case of Carcinomatosis of Glands of Unknown Origin

tlhere arc nlo sign-ts of cardiac (list -css, nor is asc'ites a Frominenit feature. \Vhite, in a r-Cecent description of Pick's disease, states: 'Polyserositis is due to tuberculosis, associated w-itli pneunionii , or, mlost comlmllonky, of lnknowIn origin. T'1li p)leure ind pericard(i urn are the seIous cav'iti's genrally lvolved, bLut SOnietillmeS tle(' pe'lritoilnuill is also aIffected. '[ lie intfectionI beg,ins as all acute process, somiletimiles inisidliouis n(I ob)ScUr-e, \vith little clinical evidence, and( Esometimes severe ani(1 dclianIose.S(L' \White admilts that polyserositis imiav Tprecede Pick's disease, and that the two conditions may coincide. Other possibilities ?of diagnosis ere conisi(lere(d and( excluided. 'Ma1ignlan1cy was eliminated, in -iewx of ,the histological report. RheumaCItiC l)ericardlitis is Usually follow-ved by (lense ,adhesions accompanied h!l hvpertrophv of the lheart. InI this bov the heart is niot Ihypertrophied, and there are no endocardial miurmiurs. Portal cirrhliosis is scarcely worth conisi(lerationi, on account of the absence of ascites, wNhich is such a promi.nent feature of this condclition. In expressing my tlianlks to Professor Youngfoithe pathological report, to Dr. Douglas Boyd foir tht radcio(g>ram11s, andl to Drs. Fisher and (].albraith for the' clinical notes, I imlust nlot omit the patient. He has bxeen very initereste(d in every procec(tire carriedi Out, and(i Imlost co-operative in all the investigations to whI'l he hias been subjected.