“…The latter account for about 1 in 430 births in England and Wales as a whole (Nash, 1963), but as many as 1 in 200 births in some areas (Laurence and David, 1963). Most of the more recently published series of cases of spina bifida cystica have either been based on small numbers (Harnack and Kirsten, 1959; Klein, Delegue and Engel, 1960;Mletzko, 1960;Regenstreif, 1961), or have been approached from a largely surgical point of view (Ingraham, Swan, Hamlin, Lowrey, Matson and Scott, 1944;Macnab, 1957;Klug and Tzonos, 1961;Wilson and Llewellyn, 1962;Guthkelch, 1962;Sharrard, Zachary, Lorber and Bruce, 1963). No real attempt seems to have been made to evaluate the natural history of the disease, though Norman (1949) followed up and reviewed all the cases seen at The Hospital for Sick Children, Great Ormond Street, London, from 1938 to 1947, that is in the years before antibiotics were in use generally, in order to get some idea of the natural course.…”