The following experience seems sufficiently remarkable to be worth reporting. The cases mentioned all occurred in my practice during the six months from Dec. 1, 1908, to June 1, 1909, in a rural community having a radius of less than four miles, with the center about seven miles northwest of Norborne, Mo.
I attended in this community six cases of frank lobar pneumonia and eight cases which I diagnosed pleuropneumonia. These latter failed to show clear physical signs of consolidation, the clinical picture being that of a severe pleuritis. All but one, an infant, however, raised a small amount of slightly "rusty" sputum. One of the pneumonia patients and six of the pleuropneumonia patients developed empyema as a sequel. Another pleuropneumonia patient had a large serous effusion, making eight cases of effusion out of the fourteen, seven being purulent and one non-purulent.