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JAMA. 1900;XXXIV(11):668-669. doi:10.1001/jama.1900.24610110028001k.
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D. V. is a full black, a laborer by occupation, 30 years of age. His family history has no bearing on the case. Previous to April last he had had no disease of any importance save an attack of dysentery six years ago. He has used alcoholics, but not in excess.

In April, 1899, he began suffering from chills and fever of an irregular type, for which he took calomel and quinin without effect; his bowels were constipated at this time.

On July 6, the man was admitted to the hospital, under the care of Dr. Jules Lazard. There was high temperature, with enlarged and tender liver. Exploration in the mammary and in the mid-axillary line brought out blood only. Blood examinations made by the pathologist of the hospital, Dr. O. L. Pothier, excluded malaria and typhoid fever. Examination of the lungs by Dr. Lazard revealed dulness, bronchial breathing, moist


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