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Emil Bogen, M.D.
JAMA. 1927;89(1):50. doi:10.1001/jama.1927.02690010050031.
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To the Editor:  —The case reported by Dr. George L. Carrington (The Journal, April 30, p. 1395) as "Bilateral Diaphragmatic Pleurisy Simulating Perforated Gastric Ulcer" appears so typical of arachnidism that this diagnosis has been made independently by a number of physicians. Comparison with the description of arachnidism (The Journal, June 19, 1926, p. 1894) leaves little doubt as to the identity of the condition.The history of a spider bite in a toilet followed in less than two hours by severe pains in the back and epigastrium, rapidly increasing in severity to the point of writhing and groaning from the intensity of the pain, with a feeling of impending death, vomiting, a rigid, boardlike abdomen, but without localized tenderness or point pain, a leukocytosis developing after several hours, a trace of albumin in the urine, and no response to large doses of morphine and codeine, occurring in a district


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