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December 1, 1923


Author Affiliations

Omaha Assistant Professor of Medicine, University of Nebraska College of Medicine

JAMA. 1923;81(22):1877-1878. doi:10.1001/jama.1923.26510220003011b

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Marsh 23, 1922, I was called to see a white man, aged 55, who presented such a unique group of physical signs that I deem them of enough significance to report. This case is not at all new, for many such have been described previously.

On a hunting trip, six months before, the patient had a cold followed by a cough, with considerable chest pain. Following his outing he felt weak and was easily exhausted, and the cough persisted. Since this time he had noticed some dyspnea on exertion, but had been able to carry on his work as a barber without any great difficulty, until five days before I saw him, when he was awakened suddenly at night with orthopnea. The following morning he noticed that his face was badly swollen and his skin was blue. These conditions had persisted, so that he was compelled to stay up; for

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