Case XXII (4).—History.
—The patient, C. T. S., entered the Cook County Hospital May 8, 1907, to the service of Dr. Ryerson. He complained at the time of dyspnea, pain in the right side of the chest, occasional night sweats, chills and fever. His right ankle was painful and swollen, and on the face and left side of the abdomen were cutaneous lesions which his physician had diagnosed and treated as lupus. The first of these to occur was a small papule over the eleventh rib on the left side, discovered accidentally in December, 1906, while scratching his body. This ulcerated and gradually increased in size until March, 1907, at which time it measured an inch in diameter, and was treated as lupus, without benefit. A similar lesion developed on the left side of the chin after the top of a small papule was cut off during shaving.