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Raymond J. Reitzel, M.D.; Charles T. Stone, M.D.
JAMA. 1928;91(17):1288-1289. doi:10.1001/jama.1928.92700170002015a.
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Mrs. J. E. L., aged 28, admitted to the John Sealy Hospital, Oct. 10, 1928, when seven months pregnant, complained of shortness of breath and swelling of the feet. She gave a history of having had "heart trouble" following a miscarriage eight years previous (1920), at which time she developed edema of the feet and "water around her heart." Twice since (in 1922 and in 1926) labor had been induced during the sixth month of pregnancy because of cardiac failure. She had mumps, measles and frequent attacks of tonsillitis up to the age of 9, when her tonsils were removed. Since that time she had had three different attacks of pneumonia. In 1919 the appendix and a "tumor of the ovary" were removed. She was married to her second husband and had one son, 10 years of age, living and well.

Examination revealed carious teeth and a papulopustular rash on


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