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B. O. Le BLANC, M.Ph., M.D.
JAMA. 1907;XLVIII(12):1030. doi:10.1001/jama.1907.25220380046002e.
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Patient.  —Mrs. H. B., aged 71, a rather spare person, active and energetic.

History.  —The patient had scarcely ever had a day's sickness in her life up to the present illness. The family history was excellent, except that one sister died of carcinoma of the uterus some years previously. The present illness began with malaise, slight jaundice, and an evening rise of temperature, about 100-101 F. This was treated as an ordinary catarrhal jaundice of malarial origin, but the symptoms gradually grew worse. Dr. A. A. Allain, of Bayou Goula, saw the patient at this time and recognized some serious trouble. I first saw her in consultation with him, then together throughout the case.

Examination.  —The skin was deeply jaundiced. Heart, lungs and kidneys were normal, but analysis revealed an abundance of bile in the urine. Microscopic examination of the urine showed only bile pigments, no blood. Liver dulness was


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