A syndrome described under such titles as cholera infantum, alimentary intoxication and anhydremia has long been known. No universal agreement seems to exist as to etiology. In general, parenteral infection has been credited with merely a minor rôle. Some authors mention that the condition may possibly be due to parenteral infection, while others are of the opinion that such infection only ushers in the condition by lowering the patient's resistance. That parenteral infection bears a relationship to gastro-intestinal disturbances is well recognized, but that it may be a direct cause of this most severe type of disturbance has been emphasized only recently. About a year ago, almost simultaneously, one of us1and Marriott2recorded observations to the effect that a direct relationship may exist between a certain type of acute mastoiditis and "cholera infantum." At the same time the other of us3stated that the same clinical