History.
—On July 28, 1907, Dr. A. W. Hon was called to see Mrs. F., a rather delicate woman, aged 44. She was complaining of great prostration, nausea, some dyspnea and a sense of oppression and pain in the precordial region.
Examination.
—I saw the patient in consultation July 30. An examination at that time revealed, besides the symptoms above enumerated, the following: Normal temperature; slight puffiness of the skin, notably of the hands and face; mild degree of palor, but no cyanosis; abdominal viscera normal; lungs negative except accelerated respiratory movements, but not a labored breathing; urine and blood negative. The conspicuous sign was an extreme grade of tachycardia. The pulse, although weak, was palpable at the wrist, but could not be counted there. The rate, as determined by auscultation and a sphygmographic tracing, was 210 (Fig. 1). The heart was small; its sounds were clear, with accentuation of