The case was seen in Dr. Howland's service in the Harriet Lane Home of the Johns Hopkins Hospital. It was that of a boy, between 5 and 6 years old, who was admitted Aug. 22, 1913, having been transferred from the Home of the Friendless in a state of coma.
Little was learned of his early history except that he had had in the eight preceding months two attacks of otitis media, and that for two years he had been subject to rather frequent and severe bleedings from the nose.
He seemed as well as usual up to five days before admission, when he began to complain of pain in his face and head, to be restless at night, and to look ill. The next day stiffness of the neck was noted, and the child vomited on several occasions. He became rapidly worse, and convulsions and coma developed the day