Abstract 1. 1. What is considered the second case of syphilis of the stomach necessitating total gastrectomy is reported in detail and compared with the only previously reported case. 2. 2. The diagnostic criteria and the surgical indications for surgery of gastric syphilis are reviewed. 3. 3. The technique of total gastrectomy is illustrated and the importance of omitting a jejunojejunostomy is stressed. 4. 4. Life may be maintained successfully for an indefinite time when total gastrectomy has been done for a benign lesion even though a severe degree of anemia develops. The anemia may be satisfactorily controlled by medical means. Since this case report was submitted to the publishers, there has been an interesting follow-up on the patient: He was readmitted to the John Gaston Hospital Jan. 9, 1941, sixteen months after operation, with lobar pneumonia. Response to sulfathiazol was prompt and recovery rapid. His red blood cell count was 4,500,000 and the value for hemoglobin was 13.2 Gm. He was eating three meals a day. Each meal consisted of an unrestricted food selection, and he could eat as large a quantity at one meal as he had ever done. He had had no regurgitation of food for six months. His weight was 165 pounds, which represented a 50 pound gain since his operation. X-ray studies revealed that the proximal loop of the jejunum had dilated to about two times normal size and was emptying normally.