Carl A. Hedblom, A.M., M.D.
JAMA. 1916;LXVI(23):1777-1778. doi:10.1001/jama.1916.02580490025009.
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A married woman of 26 was in her fourth pregnancy in five years. The first two babies had died of marasmus; the third was living and well. The husband was in good health. There had been no known tuberculosis or cancer in the family. Except for measles and scarlet fever in childhood, and malaria five years before, the patient had never been ill. General physical examination showed normal findings excepting for rather marked anemia.

The patient did not menstruate between the last two pregnancies. She presented herself for admission one week before the onset of labor because the "waters had broken." There had been only a little dribble, but it continued in small amounts until labor set in.

At admission the temperature was 99.2. Labor pains had begun three hours before. The abdominal tumor corresponded to that of an average sized baby in cephalic presentation. Only vaginal examination was made


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