“I am sending you sketches of a heart of a new born which may interest you....a child that was feeble from birth, lost weight rapidly, and developed an infection of the bladder and kidneys, apparently through a patent urachus, and died on the twentieth day. There was no cyanosis or other evidence of a circulatory disturbance during life… [t]his finding together with the presence of various abnormalities; supernumerary finger and toe, bilateral dislocation of hips, and patent urachus, had suggested the presence of a cardiac anomaly.”