1953, with a mortality rate of 8.9 per cent. During the latter period, patients accepted for surgical treatment were older than those in the preceding period.Fifty-four operations were performed in 50 patients: 24 (44.4 per cent) were for acute cholecystitis with stones, and 28 (51.9 per cent) were for chronic conditions. These conditions included calculi either within the gallbladder or the common duct. There were only 2 operations in which stones were not involvedone for a dilated cystic-duct remnant and one for an obstructed common duct, the cause of which was not determined. If acute cholecystitis, common-duct stones and fistula formation are considered to be complications of biliary-tract disease, then 35 (67.3 per cent) of the operative procedures were of greater magnitude than those commonly associated with the surgical treatment of chronic cholecystitis with cholelithiasis (Table 1). 670 RICHARD C. KARL AND FRANK GLENN Vol. III