History.—K. K., a girl, was born in Greece, Aug. 12, 1912. She entered the Children's Medical Service of the Massachusetts General Hospital, Aug. 15, 1916. Her parents were Greek, and reported that, although they themselves were well, they had lost the first two children, in Greece, of a disease similar to that from which this child was suffering.
The patient came to America in December, 1915. In January, 1916, she had pneumonia, followed by anemia and enlargement of the abdomen. Coincidentiy, she became weak and listless, and the symptoms became severe enough to bring her to the hospital.
Physical Examination.—The physical examination showed a pale, poorly nourished, white girl of normal intelligence. The head was symmetrical, and measured 48.5 cm. The pupils were equal and reacted to light. The ears, and ear drums were normal. The throat was normal. The heart dulness to percussion