On the afternoon of May 7, 1915, I was called to the Indianapolis City Hospital to make a Roentgen examination of the esophagus. The patient had been admitted to the hospital that afternoon and had alarmed the intern, so he called a member of the attending staff. History. —Mr. H. C. B., aged 58, white, a native of Ireland, married, in the real estate business, with negative family history, had had syphilis forty years ago and myocarditis one year ago; he denied gonorrhea, and there was no history of swallowing escharotics. The present illness began six months ago with difficulty in swallowing. The patient was unable to swallow solids or liquids. He then got better and worse. This continued until one week ago, when he had a hemorrhage of bright red blood which he thought was from the stomach. Up to the time he had this hemorrhage he had gradually