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of these empyemata, and their treatment consisted of multiple aspirations and antibiotic replacement at different sites. Intercostal drainage in such cases was contra-indicated. Spontaneous pneumothorax per se required no treatment other than that of the underlying infection. By contrast, tension pneumoor pyopneumo-thorax constituted an acute medical emergency. Emergency treatment consisted of aspirating air through a needle thrust into the pleural cavity, after which the problem was one of sucking air out of the pleural cavity faster than it entered. A simple and effective system consisted of the rubber cap from a transfusion bottle, through which a large bore needle or trocar and canula had been thrust into the pleural space. One of two pieces of polythene tubing of equal length is inserted so that its distal end is through the needle or canula, which is then withdrawn. The second piece ofpolythene is used to measure the length within the chest. Finally the rubber cap is strapped to the chest wall and the system connected to an electrical suction pump. If the lung can be kept expanded for forty-eight hours, it sticks and causes no further trouble. Residual shift of the mediastinum to the side of the lesion had caused anxiety as to whether pleural thickening might permanently interfere with re-expansion and function of the lung, which raised the question of decortication during the acute phase. Expectant treatment had proved amply justified, although in one case two years had elapsed before the mediastinum finally became central. When referring to lung "cysts" the term was used to cover the cystic phase characteristic of staphylococcal pneumonia without implying that they were true cysts. The typical "soap bubble" or "egg-shell" cysts were shown in some cases to disappear as rapidly as they came, while in others they persisted for several months or longer. Persistent cysts, provided they gave rise to no symptoms, required no treatment but where they were subject to recurrent attacks of inflammation or caused symptoms from air under tension, surgical excision had to be undertaken. Of the complications during the acute phase, meteorism proved an additional embarrassment to respiration in infants, which the passage of stomach and flatus tubes did little to relieve. The importance of the correction of rapidly developing animia, which may be easily overlooked, was stressed. Bronchiectasis was one of the late complications of severe staphylococcal pneumonia. Difficulties in diagnosis could arise from confusion between diaphragmatic hernia and pyopneumothorax, although X-rays in different postures could often settle the point. It could be extremely difficult to differentiate loculated pyopneumothoraces from cysts containing fluid in the lung itself. Needling of the latter in error could result in unpleasant complications such as pneumothorax and surgical emphysema. In conclusion it was shown that although staphylococcal pneumonia was not a common condition, the correct treatment of the primary infection and its complications produced gratifying results.