Whereas rupture of a cerebral vessel due to arteriosclerosis is not an unusual accident, the spontaneous rupture of vessels elsewhere in the body is comparatively rare. A review of the literature reveals reports of rupture of vessels of the extremities, renal artery, cystic artery and hepatic artery, but in these cases the rupture was usually secondary to an inflammatory process. According to Fishberg,1 "arteriosclerosis of the large arteries, in essential hypertension, is present in the vast majority of cases, often in widespread form, especially if there is an associated diabetes. In the aorta and its branches there are generally well marked or severe arteriosclerotic changes, but the vessels show little more atheromatous changes than are usual at the age of the patient."
The spontaneous rupture of an arteriosclerotic vessel into the abdominal cavity is extremely uncommon, having previously been encountered three times.2 In Starcke's case a rupture