Case 1.—History.— Ann Arnholt, aged 19, an Ohio State University student, was admitted to the White Cross Hospital, Columbus, March 5, 1940. In October 1939 the present illness began with acute inflammation of the upper respiratory tract, fever, anemia, cessation of the menses, swollen joints and a mitral systolic murmur at the apex. The clinical diagnosis was acute vegetative endocarditis. Blood cultures were negative until November 16, at which time a long chain nonhemolytic streptococcus was obtained. Administration of sulfapyridine was discontinued owing to severe vomiting. In December and again in February 1940 she had a cerebral accident which on the first occasion partially paralyzed her right arm and on the second occasion the left arm and left side of the face. In March vision was blurred, acuity of hearing failed and headaches and urinary frequency developed. Repeated cultures through March 12 were reported as a short chain