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On November 15, 1887, at 3 p.m., I was asked to see B. M., a boy of 7 years, then under the care of a homœopath, and said to be dying of heart disease. I called immediately. The boy was comatose, had been so for twelve hours. The face had a characteristic pallor, the eye-lids were slightly puffy, the pupils dilated, the breathing stertorous.
I listened to the heart and heard a loud systolic apex murmur, a diastolic one at the right base, and mingling with both a peculiar whistling sound, the cause of which at the time I did not understand. Examining further, I found that the eyelids had become puffy two days previous, that the feet and ankles were now swollen, and the scrotum slightly so. No urine had passed in twenty-four hours. Excepting a few scybala, forty-eight hours before, the bowels had not moved in seventy-two hours.
DOWNES AJ. SOME INTERESTING SEQUELÆ OF A CASE OF SCARLET FEVER. Read before the Philadelphia County Medical Society, on January 25, 1888. JAMA. 1888;X(7):202. doi:10.1001/jama.1888.02400330014001d
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