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To the Editor.— The Henoch-Schonlein type of vasculitis is one acute variety of leukocytoclastic vasculitis that manifests as "palpable purpura" and is frequently associated with systemic manifestations. 1 To our knowledge it has been seen in one previous homosexual male patient who had no clinical or serological manifestations of acute acquired immunodeficiency syndrome or its variants. 2 I report here the case of a homosexual man with Henoch-Schonlein purpura and positive human T-cell lymphotropic virus type III serological findings with massive gastrointestinal tract hemorrhage and disseminated intravascular coagulopathy (DIC). The adverse outcome was atypical of the general course seen in this disease, as most patients have resolution and recurrence with ultimate spontaneous resolution. Report of a Case.— A 43-year-old homosexual male patient was admitted to the hospital for lower-extremity skin lesions, joint pains, swollen feet, severe abdominal pain, hematuria, and bloody diarrhea. He had had hepatitis A virus, hepatitis B

FRACTURES at the base of the fifth metatarsal bone occur most often as a result of twisting injuries to the foot, and are frequently mistaken for sprains unless adequate x-ray studies are made. These injuries are seen with sufficient frequency by general practitioners to warrant a brief consideration of practical management. They occur in all ages from 10 to 70. The patient hobbles into the office or clinic with a painful swollen foot on which he cannot bear weight without increasing pain. The author has seen a large number of these injuries and has used a simple, practical program of treatment. Mechanism of Injury A sudden twisting of the forefoot applies a supinator force resulting in a rupture of the lateral interosseus ligament between the cuboid and fifth metatarsal base. The attachment of the peroneus brevis tendon is torn loose carrying with it a portion of the bone. Usually there

NARRATION OF THE CASE. Mrs. W., Jewess, housewife, aged 38, was admitted to my service in the Presbyterian Hospital, Chicago, Aug. 25, 1902, with pain in the pelvis and lower abdominal region, generally of a dull, aching character, varying in intensity and radiating occasionally to different portions of the upper abdominal and thoracic regions. The pain is most marked in the right iliac region, where there is a swelling which varies in size and consistence from time to time. The latter is usually tender when palpated. There is always great aggravation of her suffering during menstruation. She also complains of frequent and occasionally painful micturition, shortness of breath, intense headaches, swollen feet, leucorrhea, and of occasional bloody stools. She also complains of a swelling in the region of the navel, of discoloration and nodulation of the skin. Duration and History. —The patient states that she