THE possibility that intravenous injection of opium in addicts might serve as a means of entry for organisms that could cause endocarditis was suggested by Lutembacher1more than thirty years ago, when he wrote of "une injection intraveineuse malpropre." A review of almost all the cases of endocarditis reported in English in the past thirty years, however, shows that venipuncture for the injection of opium or its derivatives was a possible factor in only 12 instances (table 1). An interesting group of 11 such cases, involving patients observed in a short period, forms the basis of this paper (table 2). METHOD OF ADMINISTRATION OF DRUG BY ADDICTS The method of administration of opium employed by addicts lends itself to the introduction of organisms into the blood stream. The equipment of an addict consists of an ordinary medicine dropper and a hypodermic needle, with a bit of cigaret paper