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May 23, 1925


JAMA. 1925;84(21):1591. doi:10.1001/jama.1925.02660470053030

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To the Editor:  —The letter on this subject by Dr. Ernst P. Boas (The Journal, April 25, p. 1291) is an example of the confusion caused by such articles as he quotes. This confusion has resulted in differences of opinion to be found in textbooks. The two articles in question are those of Drs. Henry Koplik and Mera Brick.Koplik asserted that cardiac dilatation and failure in pertussis could be shown by (1) increased heart size by percussion, the right border in particular being beyond the normal limit; (2) irregularities of the pulse, and (3) edema about the eyes and hemorrhages. None of these findings can stand the test of careful analysis. In the first place, percussion of the right border of the heart unless considerably enlarged is unreliable; moreover, roentgen-ray studies of the heart in pertussis in several hundred cases at the Floating Hospital in Boston have shown that

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