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Nineteen consecutive cases of subphrenic abscess which were treated in the Royal Hospital for Sick Children, Glasgow, from 1962 to 1972 are analyzed. This complication of intra-abdominal suppuration of surgery still carries a grave prognosis. Four of the patients died (21 per cent); 2 deaths were related to the subphrenic abscess while the remaining 2 were not directly related to the abscess. The mean hospital stay of the survivors was 59 days (range 30-122 days). The changing patterns of aetiology and presentation which have recently been emphasized in general surgical practice are not reflected in this paediatric series.

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been very slow, probably because the diet had not also been changed. This was shown by subsequent photographs and skiagrams (Figs. 4 and 8) and also by the examination of the eye, there still remaining a slight exophthalmos. The report of Dr. Peingold was as follows: palpobral opening narrowed, difference of about 1 nun., and probably shorter, with llertel I'Xopht.lialiuomctcr: unsatisfactory examination; exopltt.hulinos of about 1.5 nun. on right side; lower half of right cornea more covered than in the loft eye; upper lid also covering more of cornea in the right than in the left eye; pupillary reaction and motility perfect.A series of examinations was made again on this visit resulting in sonic furl her improvement. The blood examination showed: hemoglobin, 00 per cent.; red blood-corpuscles, 4,230,000; white blood-corpuscles, 6,250; neutrophils, 44 per cent.; small lymphocytes, ;"i() per cent.; large mononuclears, 0 per cent. The coagulation tinte was between three and three and one-half minutes (Wright). Wassermann and von Pirquet reactions were negative. DIAGNOSIS OF CASE AS SCUItVYThe clinical picture of the case is typically that of scurvy. Certain conditions, however, must he'excluded hecause they present some of the symptoms found in ihis case:Rheumatism was excluded hecause it is a rare condition at this age, and also because when rheumatism is found befóte the fourth or fifth year it rarely manifests itself by swelling of the joints, and when rheumatism does involve llieni liiere are evidences of inflammation. in this case not the joints but the shafts were involved, and there was no redness or evidence of inflammation.Osteomyelitis was excluded because it is a condition in which thjjre are high fever, abscess, and usually one bone involved.Sarcoma was excluded because it does not involve as n rule more than one bone; is progressive in.its course; ¡nid hecause antiscorbutic treatment has no effect on it.

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