Dear Sir/

In the course of my practicing I have lately met with a peculiar pathological condition, with which perhaps you might like to be acquainted.— A child (male) was born of healthy parents on April 17^th. 1873 and died February 12^th 1874, living 10 months, less 5 days— On my first visit after its birth, the nurse drew my attention to the very dark hue of the child, which continuing on every subsequent visit, led me to infer that there was somewhere a communication between the two circulations, most probably through the foramen ovale,¹ I told the parents that such was the opinion I had formed & that nothing could possibly be done to remedy it— the child lived on, sucked well and was fairly nourished, manifesting the usual signs of recognizing familiar objects as time went on. Occasionally at first, but much more frequently of late, the child suffered a good deal from convulsive attacks, when the countenance became of a very deep blue, almost black, and frequently seemed as if it could not live many minutes, it would then gradually recover, the dark colour would tone down, and go on for a few days, when some slight cause, such as eagerness for the breast and being thwarted, would induce another attack—these occurring more frequently as it became older & signs of teeth coming, the strength of the child gave way and it died on the 12^th. of last month— Two days after death we made a PM² and on examination of the heart, we found it resembles the heart of a fish, containing two cavities, one auricle and one ventricle— we have, at D^r Peacock’s request, left it with him, to dissect out a little more completely than we have done, and I shall then obtain from him his views as to the mode in which the circulation was carried on, and some attempt to explain how it was some times comparatively fair, and at other times deeply blue—³ All the other organs of the body were very healthy— During life we noticed this peculiarity, at times a very extreme degree of coldness of the breath, so painful to the mother that she was obliged to cover the breast with flannel, when giving suck— the fingers were very long, resembling claws— the foot also was long—with long toes, & the heel projected considerably backwards— I know of no other peculiarity worth mentioning

I remain, Dear Sir, | Your’s truly | Prior Purvis | MD Lond

Cha^s. Darwin Esq^re.