TIIE great majority of the cases of fracture of the carpal scaphoid that present themselves in tlie wards or the out-patient department of Guy's Hospital are examples of old fracture, and the reason for attending is invariably the same, viz., that .the wrist is not as good as it was, or as it should be, and that it interferes niaterially with the %v:lge-earning capacity, either because it hurts, or is weak, or for both reasons. On iriqiiiring into the history, it generally transpires that the case was not diagnosed as one of fracture a t the time of the initial injury ; usually it was regarded and treated as one of 'sprain'. I n other words, it is only when serious sequelae have arisen and failed to disappear even after some months or years of symptoniatic treatment, that a correct diagnosis is generally made ; and the acute fracture; as such, is very often missed. I n the special Fracture Out-patient Department (where all anibulatory fractures are treated), such cases are corriparatively rare ; only 9 have been found there, in a consecutive series of 3000 cases of one sort and another. I n this particular department, all cases of injury of the wrist, of whatsoever kind, are examined with the x rays as a routine procedure, and a plate is always taken ; the wrist is exanlined anteroposteriorly and laterally, and sometimes obliquely as well, so that it is improbable that many cases of fracture of tlie scaphoid are overlooked. Moreover, since the writer's attention was first directed particularly t o this class of case, the radiograms of all the Colles's fractures and other injuries in the neighbourhood of the wrist have been re-examined, and no example of fracture of the scaphoid has been discovered amongst them.I n the general surgical clinics, cases of recent fracture of the carpal scaphoid are practically never seen : i t appears, therefore, to be justifiable t o conclude that : (1) 4