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W. T. Getman, M.D.
JAMA. 1917;LXVIII(7):547. doi:10.1001/jama.1917.04270020211019.
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Case 1.  —Mrs. E. S., aged 32, sextipara, had had measles when a child, no illness since, and no history of rheumatism or infectious disease. For three years she had been troubled with dyspnea and swelling in her limbs so that it was difficult to do her housework. For the past seven months she had been unable to walk, or to sleep except when sitting up. Edema increased steadily.Examination on admission to the Buffalo General Hospital revealed great edema of the feet, legs, thighs, vulva, abdomen and face. The heart was dilated and very irregular. The apex beat was just outside the anterior axillary line. A systolic murmur was heard over the entire cardiac area. The hemoglobin was 58 per cent. The urine showed a trace of albumin and a few granular casts. A diagnosis of mitral insufficiency with lost compensation, was made.The patient had been pregnant eight


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