Case XIX ( 1 ).1—History.
—M. L., aged 42, married, a native of Poland and laborer by occupation, had lived in the United States four years. He was admitted to the Cook County Hospital April 8, 1907, to the service of Dr. Loeb with the diagnosis of acute articular rheumatism, because of the obvious swelling of the hand and foot.After admittance to the ward, the following history was obtained with the aid of an interpreter: About four months before admission he was taken with a severe cold, cough and expectoration. This interfered but little with his general health. He next noticed a pain in the back, at first felt only on motion, later when lying on the back. A month later a swelling appeared at this painful area in the thoracic region, at the left of the median line. The cough, which persisted from the onset, became more