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The proper interpretation of the ophthalmoscopic picture is often of invaluable assistance in the diagnosis of systemic disease. Lesions occurring in the fundus are always of significance and many times diagnostic but it is not sufficient simply to describe the lesion in terms of pathologic anatomy. The careful observer should make every attempt to interpret its clinical significance.During the past four years we have studied in the wards of the Fourth Medical Division, Bellevue Hospital, and in the wards and laboratories of the Newark City Hospital, the eyeground lesions occurring in bacterial endocarditis, particularly the subacute form. The significance of a rather characteristic fundus lesion was apparently not known to most of our colleagues, ophthalmologists and clinicians. We were able to find a few excellent descriptions in the early literature.Subacute bacterial endocarditis is a disease of unusual interest to the physician because of the variety of constitutional symptoms