Philip King Brown, M.D.
JAMA. 1923;80(23):1692-1693. doi:10.1001/jama.1923.26430500001013a.
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History.  —J. D., a special officer, entered the Southern Pacific Hospital, Dec. 11, 1922, in a state of collapse with marked cardiac decompensation, auricular fibrillation and dyspnea. Aug. 29, 1922, at 8 p. m., he came home worn out from a long day's work. He had been on a twelve-hour shift since July 1, with gradually increasing weakness and shortness of breath. He would have to stand outside his front door after climbing eleven stairs and get himself in hand before entering the house. He felt that he could not keep on much longer. At 9 p. m., August 29, after going to bed without supper, he had a sudden pain in the region of the heart and out to the right shoulder, vicelike and piercing. In a few minutes the pain radiated to the left shoulder, down the right arm to the elbow and across the lower chest. The


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