Case 1.—Charles C., 4 years and 3 months old, was admitted to the Children's Hospital, Dec. 31, 1917. His family history was good. He was born at full term, and had always been well, except for rather frequent "colds" during his infancy. His mother thought that his abdomen had always been large, but she had not noticed it especially until two weeks before, since when it had increased in size very rapidly. He began to fail rapidly about the same time and the last week had been confined to bed. Since being in bed he had been somewhat short of breath and had had an unproductive cough. His appetite was fair, he did not vomit and his bowels were regular. He had no symptoms pointing to trouble in the urinary tract.
Physical Examination.—He was pale and poorly developed, and showed some evidences of old rickets. His tongue was slightly