Abstract
R. H., age 35 years, an artist by profession, first consulted me March 3, 1890. The patient, a wellnourished and intelligent man of good habits, had never been sick from childhood, and reported a remarkably good family history. For some time previous he had noticed a gradual deterioration of health, as manifested by persistent insomnia, coated tongue, loss of appetite, mental and physical lassitude and an increasing tendency to constipation. A careful physical examination gave no clue to the cause of the above symptoms, save visual evidences of a rather pronounced anemia. Examination of the blood gave 2,500,000 red corpuscles to the c. m., while the hemoglobin remained about normal, 85 per cent. Some slight accentuation of the movements of the heart was discernible. The urine was concentrated, reddish in color, specific gravity 1018, with absence of both albumin and sugar. Three days later (March 6) I was hastily summoned
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