585 CLINICAL NOTES 1 behind the sternum, accompanied by a slight cough but by no pain. This soon passed off, its occurrence being completely forgotten. Early in the following January he had .a somewhat severe attack of "influenza," followed shortly afterwards by a relapse, both attacks being accompanied by severe coughing and a slight amount of expectoration of thick yellowish muco-purulent material. During the relapse he suddenly developed aphonia for several days, preceded by slight huskiness

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... of the voice, but unaccompanied by any pain. The cough and slight muco-purulent expectoration, however, continued and in March, 1902, he had an attack of dry pleurisy over the outer aspect of the left lower lobe. On recovering from this he went to the