A man aged forty-nine was admitted into the London Temperance Hospital for anaemia. He stated that he had enjoyed excellent health until about five months previously, when he noticed that he had grown very pale and was short of breath on exertion. The appetite was poor and he was very thirsty at night. These symptoms continued to increase, and he also steadily lost flesh and became very weak. After meals containing solid food he often felt a sense of oppression at the chest, but there had been no actual pain or vomiting. On examination he was found to be profoundly anaemic and very wasted. The pulse was small and feeble, the temperature elevated about a degree and a half at night, and the tongue was pale, flabby, and indented by the teeth. The stomach was slightly increased in size, and pressure over the epigastrium produced discomfort and nausea, but no resistance or tumour could be detected. The bowels were confined. There was slight oedema of the ankles, but the urine contained neither sugar nor albumin. The red corpuscles were reduced to 54 per cent, of the normal and the haemoglobin to 44 per cent. There was no excess of leucocytes or poikilocytosis. After a test breakfast about ten ounces of thick brownish-black material was removed from the stomach by the tube, which was found to consist of undigested food, mucus, and altered blood, but contained neither free hydrochloric nor lactic acid. The following day the tube was again passed before any food had been given, and several ounces of alkaline blood-stained fluid were removed. On several subsequent occasions altered blood was discovered in the stomach during the periods of digestion, but no melaena was ever observed. Despite careful treatment the patient grew rapidly weaker, and eventually succumbed to exhaustion about six and a half months after the appearance of the first symptoms. Post-mortem examination showed a large ulcerated scirrhous growth on the posterior wall of the stomach, near the pylorus. The orifice was not involved, nor were there any metastases in the neighbouring organs.