In January, 1909, Mr. S., first came to Dr. Keyes on account of frequent urination, incontinence, and a swollen testicle. There was no family history of tuberculosis, and his previous history was that given above. A twenty-four hour specimen of urine gave the following analysis: Amount 2070 cc., sp. gr., 1014, acid, urea 1.2%, a trace of albumin, no sugar, white blood cells, red blood cells, but _no tubercle bacilli_. On physical examination it was found that he had a lump in the left lobe of his prostate and also in the tail of his right epididymis. There was in addition, a dense stricture extending from the peno-scrotal angle to the triangular ligament. During the next few days, the stricture was dilated sufficiently to permit a cystoscopy which showed the bladder to be much ulcerated. The right ureteral orifice was considerably congested, and the left resembled an irregularly-shaped volcanic crater. It was impossible to catheterize either ureter. The X-ray report was pyonephrosis of the left kidney. After an injection of 2 cc. of phloridzin, no sugar appeared in the urine until two hours and fifteen minutes had elapsed. A month later, on account of his stricture having recontracted, internal and external urethrotomy were done, and it is of interest to note that in place of prostate, there was a cavity as big as a plum, with hard tubercular walls. Six days later, another attempt was made to catheterize the patient’s ureters without success. His bladder picture was the same as before. Likewise unsuccessful was an attempt to pass a Luy’s urine separator. At this time, another phloridzin test gave no sugar at the end of four hours. Two experimental polyuria tests made a week apart, showed rather poor functionating power of the kidneys. Although it was impossible to obtain separate urines from the kidneys, in view of the functional tests all pointing to an involvement of one or both of these organs, it was decided to perform an exploratory nephrotomy especially since the patient was apparently getting worse in spite of all treatment.