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JAMA. 1916;LXVI(8):564-565. doi:10.1001/jama.1916.02580340020009.
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E. W., man, aged 28, was referred to me, June 1, 1915, for regurgitation of gas, nausea, frequent vomiting, distress after eating, a continuous sensation of weight in the epigastrium and an excruciating gastralgia.

Up to the onset of digestive distress, which occurred six months previously, his past history was uneventful with one exception, a small sore on the penis when 20 years of age. This sore, having readily healed under local application, was almost forgotten.

The patient was somewhat cachectic in appearance, was losing weight, and his physician was fearful of gastric cancer.

Physical examination was negative. Gastric analysis showed absence of both free and combined hydrochloric acid, while a trace of lactic acid was present. A roentgenogram disclosed a distorted stomach evidently due to intragastric new growth. A Wassermann test was 4+.

The patient was at once put on antisyphilitic treatment appropriate for tertiary lesions, while for his


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