The case presented vague gastro-intestinal symptoms, an irregular fever, persistent tachycardia, pain, swelling, and stiff-ness in hands, knees, and ankles; smooth cold shiny pigmented, and stiff skin, with resulting involvement of the face and inability to open the mouth more than a fraction of an inch. Laboratory findings, except for a secondary anemia, trace of albumin, rare granular and cellular casts, and some red blood cells in the urine, showed nothing remarkable. The important autopsy findings were chronic atrophic arthritis, advanced sclerosis of the aorta and renal arterioles, and melanosis of the skin with generalized fibrosis.