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January 3, 1914


JAMA. 1914;LXII(1):36. doi:10.1001/jama.1914.02560260044019

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History.  —P. M., a Mexican of Indian type, aged 40, married, but for two years past separated from his wife, was referred, June 6, 1913, by Dr. J. E. Keltner.The patient was born in Chihuahua, Mexico, and lived there until he came to El Paso eight years ago. During this time he was employed as a laborer and grave-digger at a local cemetery. Seven years ago he had rheumatic pains in his legs, accompanied with fever and swelling. He was unable to work for ten months. In the summer of 1911 he had fever, chills and rheumatic pains, which again appeared in May, 1912. Shortly after this two papules appeared on the forehead between the eyebrows; then for seven months there were no further symptoms. During this time he drank to excess. Five months ago new lesions began to appear, first on the face, then on the body. The

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