This case report is submitted because of its unusual character and because of the fact that the nature of the trouble was verified by observations at necropsy. It seems best to present the facts as they occurred from day to day.
REPORT OF CASE
History.—J. B. T., a white man, aged 56, had an essentially negative history, except that he had had cerebrospinal syphilis. Three weeks previous to the present illness he finished a course of potassium bismuth tartrate, a total of 2 Gm. in ten intramuscular injections at five day intervals. The Wassermann reaction of the blood was negative and the Wassermann reaction of the spinal fluid was 2 plus. In the afternoon of March 5, the day of the present illness, he noticed some difficulty in swallowing. He had felt very well all day up to that time. I saw the patient at 10 p. m.,