In view of the present interest in the relation of demonstrable anatomical changes in the auriculoventricular conduction system to the changes in the function of this system, the present case may be found of interest. It will serve as an instance of how extensive the anatomical disturbance of the bundle may be without destruction of its function.
History.—The patient entered the New York Hospital March 18, 1912, on the service of Dr. L. A. Conner. to whose kindness I am indebted for permission to use the case. He was an Italian laborer, aged 23. Venereal infection was denied. nor was there a history of secondary or tertiary syphilitic manifestations. He had used considerable beer and whisky for the last four or five years. He had never had chorea or any rheumatic manifestations, He had had typhoid fever in late childhood, but otherwise had always been