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The course of an acute suppurative process in the cervical region may cover a wide range of clinical manifestations and give rise to pathologic changes of a bizarre character. The capricious behavior and often bewildering influences of inflammatory disease in this part of the body have given rise to diligent research and clinical experimentation in this field. In this particular study laryngologists have advanced with striking rapidity. They have learned the great importance of early recognition of the many morbid changes produced by inflammation in the neck and the value of well directed surgical efforts in reducing the outcome to something less than an inevitable slow and painful death. To the sum and total of this knowledge have been added a clearer understanding of the mode of spread of infection to the mediastinum and rational methods for the treatment of an acute suppurative process within this part of the thoracic

Forward displacement of the atlas on the axis is a comparatively rare condition, ordinarily treated by conservative methods. Operative intervention has been recorded in but few cases and only when pressure myelitis has developed. The more common unilateral or rotary dislocation will not be considered here, since it is a less serious lesion, with a far better prognosis, and ordinarily responds to the manipulative method of Walton. 1 The condition we are considering is frequently immediately fatal. In cases in which death does not occur the diagnosis at first may be easily overlooked, since there is usually no evidence of spinal cord injury. The dislocation is ordinarily a progressive one the seriousness of which is attested only by increasing pressure myelitis or sudden death. At the time of the original trauma, the common lesion is a fracture of the odontoid process at its base and loosening of the atlanto-axial ligaments