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1. Arthrography of the shoulder is a simple, safe, easily interpreted clinical test which is unusually accurate and which provides information that would otherwise be unavailable without an exploratory operation. 2. An arthrographic study is indicated in any case in which the diagnosis is doubtful. 3. The pain-obliteration, abduction-strength test provides an excellent method of selecting candidates for arthrographic study. 4. Capsulitis is an inflammatory condition infrequently, if ever, associated with rupture of the rotator-cuff mechanism. 5. Coexistence of lesions of the biceps tendon and rotator cuff is common. 6. Rupture of the supraspinatus tendon is a common complication of recurrent dislocation of the shoulder and should be looked for by arthrography or at operation. 7. Coexistence of calcification of the subacromial tissues and rupture of the rotatorcuff mechanism is not uncommon in the presence of reduced abduction strength.

1. 1. Nine cases of referred pain of bone origin are reported. 2. 2. All had been diagnosed incorrectly one or more times because the region of pain localization had been considered the seat of the disease. 3. 3. Two patients had been operated upon unnecessarily in the region of pain localization.

The results obtained in fifty-two patients treated with Hibbs spinal fusion plus internal fixation of the apophyseal joints with Vitallium screws are reported. There is a marked reduction in postoperative pain. On the average patients are ambulatory on the ninth postoperative day and leave the hospital on the twelfth. Recent experience indicates these figures may be materially reduced. Of the patients 98 per cent have returned to their same occupation; 86 per cent are able to do a full day's work; 80 per cent are entirely relieved or at most have only a slight backache; 46 per cent state their backs feel strong and 75 per cent are entirely relieved of leg ache. None have a severe backache and one has continued to have a severe leg ache. The poorest results are among the four who have a typical disc syndrome with normal roentgenograms of the spine and in whom no retropulsed nucleus pulposus was demonstrated at operation. Results are better among those patients who have been operated longest indicating that fusion may require many months. There have been no complications directly attributable to the use of screws and in no instance has it been necessary to remove them.

Prolonged abstinence from foods providing certain essentials to normal life processes results in various well known deficiency diseases which must be distinguished from changes arising in normal animals suddenly deprived of all food intake. For purposes of clarity the former may be regarded as changes arising from chronic starvation and the latter as those arising from acute starvation. It is with healing in diseases arising from acute starvation that this paper is concerned. A review of the literature reveals that investigators unanimously agree that acute starvation does not inhibit either growth or repair. McCollum and his co-workers1demonstrated that fasting would cause active rickets in rats to heal from within twenty-four to forty-eight hours. Shipley and Holt2reported studies in vitro and stated that solutions to which 51.3 millimols of sodium chloride had been added inhibited calcification in preparations of the bones of rats with rickets, while similar

Ruptures of the rotator cuff commonly are unrecognized and mistakingly diagnosed "bursitis," because they occur without clinical or radiological evidence, other than by arthrographic study. Conventional roentgenograms, correlated with 200 arthrographic studies of shoulder dysfunction, reveal six degenerative changes appearing after the fourth decade, any four of which if present, indicate a 90% probability that arthrographic study will reveal a ruptured rotator cuff. Arthrography remains without peer as a diagnostic tool in the evaluation of shoulder pain of local origin.

A REVIEW of the medical literature reveals few reports of studies concerning the recovery of sensation in skin grafts. All agree that, under favorable conditions of growth recovery of sensation in pedicle skin grafts begins at the periphery in the region of the proximal nerve supply and spreads distally. There is a temporal dissociation in the appearance of recovery. Pain sensation appears in three to six months and usually goes on to completion within a year. Touch returns in nine to twelve months, and temperature discrimination lags behind. Adequate recovery of sensation in a pedicle graft usually is followed by recovery of sympathetic innervation. Review of the reports of studies dealing with recovery of sensation in split thickness skin grafts reveals that there are two opinions, diametrically opposed. Prior to McCarrol's 1 report, recovery of sensation in split thickness grafts is described as patchy and incomplete and the rate of