E ARLY ambulation of the surgicai patient is now becoming an accepted poIicy in many surgica1 centers and clinics throughout the country. This method of postoperative management of patients has taken more than fifty years to gain a substantia1 and sound footing in our country. One of the eartiest reports on the subject was by Ries in 1899. l1 The report by Leithauser in 1941 created a great stimulus to the study of this probIem of earIy ambuIation.7 Since that time many favorable reports have appeared in the Iiterature.1-6~*-10 This report is based on the study of the effects of earIy and Iate ambuIation upon 2,955 patients who had major surgery performed at this hospita1 from September, 1946, to September, 1950. During the first two years of this period the poIicy and routine estabIished was to ambulate patients after the sixth postoperative day. After this period practicaIly a11 of the patients were ambuIated before the third postoperative day. AI1 patients ambuIated within the first three postoperative days were cIassified in the early ambuIation group, whereas those ambulated after the third day were placed in the Iate ambuIation group. AmbuIation in this study consisted of arising from bed, standing, walking and sitting either in a chair or on the side of the bed. The majority of patients in the early group were ambuiated during the first twenty-four-hour period. Those in the Iate group were ambulated from the fourth to the fourteenth postoperative day; however, the majority in this group were ambuIated after the seventh day. This sequence of activities with assistance to the patient was carried out two to three times daiIy unti1 the patient was abIe to manage his own activities safeIy. In a11 cases, whether the patient was ambulated early or late, deep breathing and leg exercises were started immediateIy after the patient reacted from his anesthetic. These activities were carried out several times a day for a period of time as required for each individual or specific groups of patients. Those scheduled for thoracic surgery received thorough preoperative instructions in breathing, upper extremity, shoulder girdIe and posture exercises. They were we11 indoctrinated prior to surgery so that their cooperation in carrying out these exercises foIlowing surgery was easily elicited. This organized program of bed and chest exercises and ambuIation was a result of a combined and coordinated program instituted, supervised and conducted by the members of the Department of Physical Medicine in conjunction with the members of the Department of Surgery and its nursing staff. It is only through teamwork with a we11 deveIoped and we11 organized Department of PhysicaI Medicine that such a program as outlined previously can be carried out.