Before considering the case which is the main interest of this paper, I wish to review certain aspects of another case. REVIEW OF PREVIOUS CASE I first performed total gastrectomy for carcinoma of the stomach in August, 1929. The patient's return to the clinic four months following the total gastrectomy, that is, in January, 1930, gave me an opportunity to make physiologic and chemical studies, which were reported in detail in 1930.1 A summary of, and comment based on, those studies is as follows: "In view of the absence of secondary anemia in experimental animals after total gastrectomy, in which more than four years has elapsed since the operation, the question naturally arises whether the cause of secondary anemia in human beings in whom total gastrectomy has been done is the result of local recurrence of the malignant growth or of remote metastasis. The cases reported by Brigham, Moynihan