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A married woman, aged 45, with an unimportant family and past history, had a sudden onset, in the middle of February, 1926, of severe, aching pains in the arm, elbow, posterior lower chest and hip on the left side. The hip pain radiated down into the knee. With the pain, there was an irregular temperature, sweating, loss of appetite and general malaise.
She was treated for rheumatism with some improvement, but the pain in the chest and hip persisted, together with fever and a gradual loss of flesh and strength.
May 1, ten weeks after the onset of her illness, she suddenly developed a cough with a slight purulent expectoration while in the recumbent position. Concomitantly, there was a diminution of the pain in her chest and hip.
Thereafter, this cough continued and gradually became worse; the purulent expectoration was more profuse whenever she assumed the recumbent posture.
von Deesten HT. RECUMBENT POSTURE COUGH WITH PURULENT EXPECTORATION: AN INDICATIVE SYMPTOM IN A CASE OF PERINEPHRITIC ABSCESS WHICH HAD RUPTURED INTO A BRONCHUS. JAMA. 1927;88(2):98–99. doi:10.1001/jama.1927.92680280028010
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