RT Journal A1 VanNuys JC, Stokes MB T1 CHronically enlarged spleen (malarial?) JF Journal of the American Medical Association JO Journal of the American Medical Association YR 1918 FD June 29 VO 70 IS 26 SP 2001 OP 2002 DO 10.1001/jama.1918.26010260003005c UL http://dx.doi.org/10.1001/jama.1918.26010260003005c AB Mrs. B. T., aged 34, was one of fourteen children, ten of whom, five boys and five girls, lived to be grown. Three sisters and four brothers are now living. The father died of dysentery at the age of 68. The mother is still living, aged 68.At the age of 10 years the patient had had a prolonged attack of fever, during which the spleen had become enlarged and dislocated downward. During this attack of fever, she had had severe constipation. Since the attack she has had many similar ones, each being accompanied by an enlargement of the spleen. Each time, after the subsidence of the temperature, the splenic enlargement decreased, but the tumor could always be felt in the hypochondrium. Ever since her first attack of fever, she has been obstinately constipated.She was married at the age of 21, and is the mother of six children, three