Memingococcal Septicaemia with Bilateral Adrenal Haemorrhage (Waterhouse-Friderichsen Syndrome)

Dr. W. O. Spence: This was a man aged 62 years whose past medical history, al' though not particularly relevant, was rather unusual. For many years he had cofl\" plained of headaches and of attacks of pain and exquisite tenderness along the le* costal margin which were only relieved by lying on the floor. He had been seen by many doctors and was regarded either as a neurasthenic or possibly as suffering frolT1 after-effects of cerebral malaria contracted during the 1914-18 war. On October 21st, 1957 he was well although not at work?he had not, in fact> worked for ten years. The following day I was sent for and when I saw him at abou 11.0 a.m., he was complaining of tremendous nausea. There was no actual vomitin? but he obviously felt very much under the weather. It appeared that earlier in the day he had passed a very large motion; I did not actually see it, but he said it was a norma coloured stool. The nausea was not relieved by passing this motion; it persisted all tn time. He could hardly stand any light; this was not a true photophobia but rather th light gave him more nausea. There was little to find in the way of physical signs: n1 pulse was good, his colour was absolutely normal, he did not respond very we .,