Although heart block is no longer regarded as a rare disease, its association with a gumma of the heart is still of such infrequent occurrence as to merit the report of every case observed. In 1905 only three titles appeared in the Index Medicus on the subject of Stokes-Adams disease. In 1906 there are forty-six references to this disease, the result of interest excited by the work of Kent, His, Tawara and Erlanger. During the succeeding years a large number of articles on heart block appear. A total of 499 papers have been published from 1903 to 1922.
The number of such cases proved to be due to a gumma of the heart is quite small. Keith,1 in 1909, collected seven cases, and Hirschfelder,2 in 1913, also collected seven cases. I have been able to find only eleven cases in the literature up to 1922, those of Rendu,3 Handford,4 Keith