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Am J Dis Child. 1923;26(6):600-602. doi:10.1001/archpedi.1923.04120180099007.
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History.  —S. J., a Jewish girl, aged 5 years, admitted to the pediatric service at the Boston City Hospital, March 2, 1923, two weeks previously had awakened at night with nausea and vomiting, a sore throat, and a temperature of 100 F. Five or six days before admission, she had a severe headache on the left side, associated with pain in the left ear, and became drowsy. The headache grew progressively worse and was present day and night. No history of convulsions or paralyses was obtained.

Physical Examination.  —The child, a well developed and well nourished girl, was irritable and uncooperative. She breathed rapidly, and the face was flushed, the tongue coated, and the pharynx injected. Marked rigidity of the neck was present, with pain on the slightest motion. The Kernig sign was positive. The temperature was elevated, and the pulse and respirations were increased. Examination of the urine was


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