—The infant, aged 1 year, came under my care Jan. 4, 1913. Family history negative. Parents both young and in good health. The patient had been a blue baby from birth. Breast-fed for a time. Ever since birth it had had an inspiratory grunt, more perceptible when the child was moved or held erect. Both skin and mucous surface constantly blue. The infant had steadily gained in weight, however, weighing 24 pounds at 1 year of age. Digestion had always been good, bowels regular, urine free.
History of Attack.
—Dec. 5, 1912, infant was suddenly taken sick with sore throat and fever, followed by a general erythematous rash. Later this rash was followed by a series of small vesicles. December 10 some swelling about the face was first noticed. The mother said breathing became more labored and rapid, so that she had to keep the child constantly in a