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In this paper the term " meningitis " is used in a clinical sense, whether the inflammatory condition is of bacterial or non bacterial origin and whether or not it involves the brain. It covers all inflammatory disease that can be included within the terms " meningitis," " meningo-encephalitis," or " ence phalitis," with the exclusion of tuberculous meningitis and poliomyelitis. The initial signs of meningitis are usually those which indicate meningeal inflammation, but clinical signs of involve ment of the brain may follow in some cases. In fatal cases evidence of cerebral damage can usually be found at necropsy. Moreover, electroencephalographic studies often show disturb ance of cerebral function even without any clinical manifestations.

The unsuspected subdural haematoma of infancy remains a numerically small but significant cause of mental retardation and physical handicap. Ingraham and Maison (1944), in their now classical paper, stressed that this condition must be actively sought if cases are not to be missed. Statten (1948) commented that their paper had stimulated interest at the Hospital for Sick Children, Toronto, and, as a result, in the next 16 months an average of one case a month was diagnosed, whereas previously the average had been one case a year. The condition has received scant attention in the British literature apart from a report of 18 cases by Guthkelch (1953). During four years of study he found that of all surgical conditions of the central nervous system seen in the first two years of life only spina bifida and hydrocephalus were more common than subdural haematoma.

Infection of the urinary tract is a common condition in childhood and one which is often overlooked. In a recent large survey significant bacteriuria was found in 1 % of a schoolgirl population, many of these children being symptomless (Kunin et al., 1962). De Luca et al. (1963) found an average delay in diagnosis of 18 months, and only 28% of Burke's (1961) series were referred with the correct diagnosis. In recent years we have become aware of typical pyelonephritic scarring in the excretory pyelograms of young children who have been investigated because of a urinary infec tion. The association with vesico-ureteric reflux in these cases (Hodson and Edwards, 1960) has also been impressive. At the same time the grave consequences of chronic pyelonephritis have attracted increasing attention, and chronic pyelonephritis is recognized as the commonest cause of hypertension and renal failure in young adults (Rosenheim, 1959). We therefore decided to study the clinical and radiological features of urinary infections in children in the hope that a better understanding of the natural history in this age-group might lead to improved management, the prevention of scarring, and a reduction in chronic pyelonephritis in later life.

In 1956 Stevenson published the results of 119 diabetic pregnancies treated in the Royal Maternity Hospital, Belfast, during the 16-year period 1940 to 1955. As a result of his findings he concluded that some improvement in the foetal mortality should be possible and recommended (1) that there should be the closest co-operation between obstetrician, physi cian, and paediatrician ; (2) strict antenatal care from the beginning of pregnancy ; (3) admission to hospital at the twenty-eighth week, or earlier if stabilization is unsatisfactory ; (4) premature delivery at 35 weeks, or earlier if indicated ; (5) delivery by caesarean section in all primigravidae and all but a very few multigravidae ; and (6) skilled nursing of the neonate in a modern nursery unit. For the past eight years the management of diabetic preg nancies in the Roy? Maternity Hospital, Belfast, has been influenced to some extent by these recommendations. Con sequently it was decided to carry out a further review to see if there had been any improvement in the foetal mortality and whether or not any alterations were necessary in our present management.

The diagnosis of aplastic anaemia depends upon the demonstration of hypocellularity of the bone-marrow, and before making the diagnosis it is essential to demonstrate this by appropriate marrow aspiration, bone-biopsy, and special investigations: Even so, this diagnosis includes a number of entities which differ in behaviour and prognosis and are prob ably due to different fundamental defects. They include congenital and familial aplastic anaemias, bone-marrow injury due to ionizing radiation, and chronic acquired aplastic anaemia. In a number of instances of acquired aplastic anaemia there is an undoubted causal relation with a chemical substance, but often there is no apparent history of an aetiological agent and, conversely, it may not be possible to define the relation of the disease with a drug known to have been previously administered. It is therefore convenient to study the idiopathic and secondary groups together. During the past 12 years 60 patients with chronic acquired aplastic anaemia have been investigated at the Postgraduate Medical School. On the basis of this experience problems of diagnosis are reviewed and influences which affect prognosis are analysed. The patients came from a wide area, including a few from overseas. Those referred for consultation tended to be the more serious cases, and the series cannot therefore be regarded as an unselected one.

This paper describes a system of computer-aided diagnosis using an English Electric KDF9 computer linked to a terminal in a busy clinical department. Data from a series of patients were recorded, coded, and entered into the computer, which then performed a Bayesian analysis and displayed diagnostic probabilities in an adaptable format. Experience in this setting suggests that computer diagnosis may be a valuable aid to the clinician.

Disorders of genetic origin may cause morphological or metabolic disturbances. A number of recognized screening procedures, e.g. palm printing, buccal smears and paper chromatography, are useful in the recognition of these disorders.Additional procedures for more detailed analysis of the genetic defects, e.g. aminoacid analysis, gas chromatography and chromosome analysis, have been developed and are employed in specialized centres.

One of the established principles in the selection of patients for mitral valvotomy is that the symptoms must be disabling enough to warrant the risks of surgery. In practice this is generally taken to mean that there must be at least moderate dyspnoea before operation is recommended. In this paper we present evidence that mitral stenosis may become serious and potentially lethal without causing any definite symptoms.

For over 25 years sporadic reports have been appearing in the literature of cases of eosinophilic granuloma arising in various parts of the gastro-intestinal tract. Kaijser (1937) described the first cases. In a search of the literature, which although extensive is not claimed to be exhaustive, 47 papers were found, describing a total of 89 cases. They occurred through out the alimentary tract from pharynx to rectum, though the majority were in the stomach and small intestine, and they