According to Libman,1endocarditis may be classified as rheumatic, syphilitic, acute bacterial, subacute bacterial and indeterminate. The indeterminate group includes a number of heterogeneous types characterized by nonbacterial, verrucous endocardial deposits, which cannot clearly be placed under the preceding headings. Certain forms in this indeterminate group, occurring toward the end of chronic diseases like carcinoma, leukemia or nephritis, were called terminal endocarditis. These corresponded to the cachectic endocarditis mentioned by Harbitz.2In 1923 Libman and Sacks3further segregated from the instances of the indeterminate group four cases in which the clinical and pathologic features were sufficiently uniform to constitute a definite syndrome. Because of the peculiar appearance of the gross endocardial lesions in this group of cases, the condition was termed "atypical verrucous endocarditis." In 1932 one of us (L. G.)4made a detailed study of the pathologic changes of the hearts of eleven patients with