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excluding rheumatism, or simple neuritis. Inflammatory conditions of the nerve roots (radiculitis) are often associated with inequality of the pupils, due to sympathetic involvement in a position above the point where compression of the lower trunk takes place at the first rib. Syringomyelia must be excluded; and it is interesting to note that Murphy has drawn attention to an association between this disease and the presence of cervical rib. J. B. Murphy states that occasionally elongation of the transverse process of the seventh cervical vertebra, or acute angulation of the first rib at its juncture with the transverse process, produces the same symptoms as a true seventh cervical rib. Great care must be taken to ascertain before removal of a cervical rib that it is the real cause of the trouble. At least one case is described where a cervical rib was present, but the compression of the nerve was due to a normal first rib, and the symptoms disappeared after removal of the latter. I have to thank Mr. A. I(. Henry for his assistance in connection with the literature on the subject, and for valuable suggestions made when working on the cadaver. Dr. McAuiey kindly assisted me at the operation, and Sir Harold Stiles wrote me a full description of the operation as performed by him. Dr. Hayes, who l~nows tbe patient personally, after much trouble obtained the photograph shown--the region is full of pitfalls and difficulties from a radiologist's point of v~ew.

A case of diabetes mellitus with local infection and acidosis treated by the allen method (abstract)