A HITHERTO UNDESCRIBED FORM OF VALVULAR AND MURAL ENDOCARDITIS

In previous communications,¹cases of endocarditis were classified as rheumatic, syphilitic, bacterial—acute and subacute—and indeterminate. The latter term was introduced to designate certain cases which do not fall into the category of any of the well-recognized groups of endocarditis, and the etiology of which is not yet established. The term is used to include (a) the cases of so-called "terminal" or "cachectic" endocarditis, occurring at the close of chronic diseases such as carcinoma, tuberculosis, nephritis, and leukemia, and (b) cases of "atypical verrucous endocarditis." The purpose of the present communication is to discuss the cases included in the latter group, which we believe represent a hitherto undescribed form of endocarditis. We are at the present time reporting the study of four cases, clinical observations of which were supplemented by postmortem examinations. In each instance, there were peculiar valvular and mural lesions, which differed in morphology and localization from those generally