_Case I_,—E. P. was first seen in September, 1907. He then complained of an ulcer on the penis and frequent and painful urination. One brother had died of pulmonary tuberculosis. The ulcer had appeared a year previously, beginning with a redness of the meatus, which persisted, with superficial ulceration. No history of exposure. In April, 1907, the dysuria began, and at the time he first consulted Dr. Keyes, he was urinating every two hours, day and night. He had also experienced a chill three weeks before this time. The patient had never noticed any blood in his urine. His weight had dropped from 170 to 149. Physical examination showed his kidneys to be insensitive, and his prostate and seminal vesicles were negative. The urine was acid, showed a fair amount of pus and albumin, but no casts. No. T. B. bacilli found. A month later the patient was seen again. In the interim he had suffered an attack of fever (T. 105), and also an intense pain in the right testicle and right side, lasting four days. The urine suddenly showed a great increase in pus after which relief followed. All this time the prostate remained unchanged, but the right kidney was now tender on palpation. During the next couple of months the patient showed a quite perceptible general improvement on anti-tubercular treatment, but had at times passed some blood in his urine. However, in January, 1908, he began to have pain all over the abdomen. Cystoscopy having been unsuccessfully attempted two months previously, separate urines from the right and left kidney were now obtained by means of the Luys’ urine separator and showed the following: From the right kidney, 14 cc. of urine, containing 2.4% urea, and a slight amount of pus; from the left kidney ¾ cc. of urine, a very little urea and a large amount of pus. A nephrectomy of the left kidney a few days later revealed a small tubercular pyonephrotic kidney, with an apparently normal ureter. In April, 1910, this patient was heard from directly for the last time. By virtue of his social status he was forced to lead a life which was not in conformity with his personal welfare, doing hard manual labor most of the time. And while he has suffered various setbacks, he always managed to readily recuperate under enforced rest and anything like proper hygienic conditions. He had even gained considerable weight when, another setback occurring, due to over-exertion, he went to the Adirondacks, immediately contracted pneumonia, and died within a week of its beginning.