Infective hepatitis with hepatic cirrhosis.

THE patient was a thirty-four-year-old British soldier who had qeen a prisoner of war in German hands from 1940 until he was liberated in 1945. He was on the "thousand-mile forced march" from Poland to Germany in the face of the aqvancing Russian Army. While in captivity he had little food to eat and his meals were very small. On return to the U.K. he found that he coul(l never eat more than very small meals without feeling sick and, vomiting~ This state of affairs continued, but in spite of that he must have eaten adequate food as he appeared to be of average nutrition. He was admitted to B.C.0.F.j29 General Hospital on 16th February, 1951. A fortnight previously, he reported sick when he began to complain of anorexia and nausea. About nine days .later, he noticed that his eyes and skin were yellow in colour and that his urine was dark. On admission to hospital he was deeply jaundic,ed, the liver was palpable two finger-breadths. below the right costal margin and it was tender. The spleen was just palpable, the stools were pale and the urine ~ontained bile pigments, bile salts and an increased amount of Ufobilinogen, but nothing abnormal was noted on microscopic examination. , He was febrile (T. 190.8° F.), but he became afebrile the next day. Blood films, thickandthin, showed no evidence of malarial parasites, etc. He was treated with a high protein, high carbohydrate, high vitamin and fat restricted diet. 21st February, 1951: Serum bilirubin, 12.8 mg. pe~ cent. Thymolturbidity, 8.0 units. 7th March, 1951: W.B.C., 8,000 per cu. mm. (Polys, 62 per cent. Lymphs, 32 per cent. Monos, 2 per cent. Eosins, 4 per cent.) • ' 8th March, 1951: Serum bilirubin, 9.75 mg. per cent. Thymol turbidity, 10 units. Takata Ara-positive. ) I