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Patient. —J. C., aged 37, single, admitted Oct. 6, 1910, to the Buffalo General Hospital. Family history, negative. Usual diseases of childhood. Railroad accident at the age of 7 leaving right ankle ankylosed. Typhoid at 17; recovery complete. At 19, acute rheumatism of joints of legs for six months; another attack at the age of 21, which lasted nine months; recovery. Two attacks of gonorrhea at ages of 23 and 25, leaving moderate stricture; chancre at age of 35; patient had been treated for that and for the stricture. Present Illness. —For some time past, patient had a sensation about the body like a girdle pain and some numbness of the legs; had some trouble in walking. Sept. 25, 1910, he felt a sudden shock like an electric current go through the body; abdominal muscles grew tense; patient had to be taken home and later entered the General Hospital. Complaint

Pain has been considered rather uncommon in multiple sclerosis, as a survey of textbooks will reveal. Yet in a necropsy study of 46 cases, Carter et al 1 recorded pain in 42% of them and it was the first symptom in 11%. Their patients had a severe form of the disease, having reached the hospital and remained there until death. McAlpine et al 2 found that pain, especially in the low back, may be early or late in the course of the disease. They noted that Abb and Schaltenbrand defined a pseudorheumatic type of multiple sclerosis characterized by muscle and joint pains or by neuralgia, but without fever. Pain in the limbs occurred in about one third of the patients of McAlpine et al with the spinal form of the disease, but girdle pain and neck pain were rarer. Head pain or trigeminal neuralgia are unusual in multiple sclerosis. However