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August 30, 1902


JAMA. 1902;XXXIX(9):492. doi:10.1001/jama.1902.52480350030002

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Round Lake, lying about midway between Troy and Saratoga, has a winter population of about four hundred, and of these about half had the disease which I am about to describe.

Before this epidemic I had never heard of the so-called "Fourth Disease," but there was something in this so entirely different from anything I had previously seen, that very early I came to the conclusion that it was something new and I now believe that it was the so-called "Fourth Disease" described first by Dr. Dukes in 1900, and by Dr. Simpson in the Archives of Pediatrics for September, 1901.

March 11, 1901, I was called to the family of Mr. M. L., as their three children were all taken slightly ill at about the same time, with temperatures of about 99, pulse 86 to 100. The throat showed what looked like a follicular tonsillitis. The glands of the

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