Prophylactic methotrexate therapy given to 33 cases o f hydatidiform mole reduced the incidence of malignant trophoblastic disease from 17.3 per cent zo 6.1 per cent and prevented the development of choriocarcinoma without producing any mortality. Toxic effects were more common with oral as compared with intramuscular administration. Two cases of hyperpyrexia are described, and one was further complicated by endotoxin shock. The number of courses of methotrexate given varied from one to jive courses, depending on the pattern of H.C.G. excretion. fell below 100 m.1c.u. per 24 hours.Chemotherapy was discontinued when urinary gonadotrophin
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