wee! ete Us = . tat 19 none “A, co leet ae ee og ne 0.3 to 1.0 cm. slightly raised nagenta or purple, circular lesions, which were not tender. The heir on the head was closely cropped and over the cranial vault was seen a large stellate shaped cracking of the skin of the scalp, the center of this star being a lesion approximately three centimeters by two and one half centimeters covered by a raised golden flaked discharge, The branches running out from this center were covered with a similar taterial. area was tender and boggy. This entire Over the wrists, on both hands, and also at the base of the toenails were small colorless to purple vesicles on a red background, On the base of the left thumb, dorsal surface, there was an ulceration about 2.5 centimeters by 2 centimeters covered by what appeared to be normal granulation tissue, There were many discreet firm nontender lymph nodes in the cervical, axillary, epitrochlear, and inguinal lymphatic chains, The left ear was de- scribed atove and in the left auditory canal was a vurulent sanguinous discharge, The scleraewere muddy, There was 2a slight injection of the conjunctivae. fundi revealed increased perivascular sheathing of the arteries, The In the nzéso~ pharynx there were no petechiage. The tonsils were moderately enlarged. corners of the mouth were cracked, crusted and bled on slightest touch, The On the chest wall at the junction of the sternum end the second rib on the left was a cyst-like mass lying beneath an acne scar, was not enlarged, Guality, The lungs were clear. The rate and rhythm were regular. ‘The sounds vere of good There was a grade II systolic murmur at the apex and along the left sternal border in the fourth anda fifth interspaces, muscled, The heart The abdomen was well The liver was down two finger breadths (3 centimeters) below the costal 2argin in the mid-clavicular line; it was nontender, The spleen edge could