The Mechanism of Syncope After Coughing

Abstract

53 6-42 9/2/t53.. 215 Blood levels of over 30 mg. per 100 ml. are apt to cause toxic phenomena (coma with or without convulsions), and if the level exceeds 50 mg.the toxic phenomena can be lethal (Christie et al., 1951).To maintain this blood level in an adult requires about 40 to 50 g. of ethyl vanillate daily by mouth, and in a child 0.75 to 2.5 g. per kg. of body weight a day.More recently, Christie (1952) said that ethyl vanillate was the only therapeutic agent of any value in histoplasmosis, though it was not satisfactory.The patient here described received 45 g. daily from February 2, but part of this was vomited.From February 5 he received and retained 50 g.daily. SummaryAfter a brief review of the cases of histoplasma infec- tion previously published in Great Britain the second case of disseminated histoplasmosis to be reported is described.This case was fatal in spite of treatment with 45-50 g. of ethyl vanillate daily.Some information is included on culture of the organism, as in this case it showed certain cultural peculiarities.We are grateful for the help we received from many sources in the treatment of this case.We would particularly like to