October 2, 1896, a patient, 32 years of age, entered Cook County hospital, Chicago, with evidences of an acute, febrile disease. He gave the following history: When 2 years old a consultation of physicians was held—the child always having been so delicate that it was necessary to carry him about on a pillow, at that time being very poorly nourished and developed, unable to walk, and having at frequent intervals attacks of marked cyanosis. The consultants told his mother that he could not live to maturity. At the age of 17, Prof. Lyman of Rush Medical College demonstrated the case in his clinic as one of cardiac disease. During his entire life, upon marked exertion or excitement, the patient had attacks of pronounced cyanosis.
Upon entrance to the hospital, physical examination revealed the following: General development and nourishment good, clubbed finger ends, color ruddy, no evidence of cyanosis at this