A white man, aged 50, a truck driver, was admitted to the medical service of the Cincinnati General Hospital, March 26, 1930, complaining of chills and fever of five days' duration. The chills had been occurring daily and were followed by profuse sweating. After the first rigor he experienced a severe pain in the left epigastrium. He felt a swelling there, which had remained unchanged in size.
There had been no previous abdominal pain and no digestive disturbances other than occasional flatulence and eructation of sour material. The bowels were usually constipated. A penile lesion had been present twenty-five years before, which was thought to be a chancre. When 10 years old he had chills and fever, which disappeared after the administration of quinine. He had received numerous intramuscular injections in the hips.
The patient was somewhat undernourished but did not appear acutely ill. There was a subicteric tint to