The Shwartzman phenomenon, as experimentally produced in animals, is a well-known and characteristic condition. Clinically, there are several syndromes whose course, pathology, and association with bacterial toxins strongly recommend them as human counterparts. This case is presented as another clinical example of the generalized Shwartzman phenomenon, with emphasis on the neurologic symptoms and neuropathology. An attempt to unify the diverse experimental observations on this phenomenon has been made which suggests a relationship between acute hemorrhagic leukoencephalitis and thrombotic thrombocytopenic purpura. The gap between these 2 entities can be bridged by the picture of the Shwartzman phenomenon, thus providing a spectrum. Report of Case The patient was a 63-year-old married Negro woman, admitted to the University Hospital June 12, 1958, for vomiting and chest pain of increasing severity. She had enjoyed good health until January, 1958, when she started having bouts of nausea and feelings of distension in the left upper