In August, 1923, a white man, a mill operative, aged 46, was referred to me complaining of stiff arms and legs. His trouble had started in November, 1922, with diarrhea, which had continued for six months. In December, 1922, his knees had become stiff and painful on rising, and after a week or so the pain had extended to the ankles, which had become much swollen; the skin had become smooth, shiny, red and angry-looking from the middle of the feet to the knees. As in one of the cases reported by Longcope,1the man was thought by his physician to be suffering from chronic interstitial nephritis, at this time. The shins were extremely painful to the touch. After a few weeks, the wrists became painful; the forearms swelled and became stiff and painful, and the skin on the wrists became red. The temperature was taken repeatedly and found