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THE USE of an operative procedure to control disease in a given area of the body may be dependent upon the morbidity and mortality associated with such a procedure. It has been stated,3"In some of our large teaching hospitals a thyroidectomy has become a rare procedure." The statement is undoubtedly true relative to toxic goiter, but we doubt that it holds for other thyroid diseases. During the past year there have been articles published in the surgical literature in which the rate of complications, as particularly related to recurrent laryngeal nerve injury and permanent hypoparathyroidism, seems to be unusually high.1,2, 4,7,8It is because of these reports that a study of all thyroid surgery, carried out over a five-year period in a large hospital center, was undertaken. Material During the period March 10, 1958, through Dec 31, 1963, 1,002 patients underwent thyroid surgery at the Washington Hospital

SURGICAL DRAINS have passed through many modifications and improvements since the days of Hippocrates when they were first introduced in the treatment of empyema. In 1890, Charles Bingham Penrose introduced the now famous Penrose drain. Through the years, certain basic principles of drain management have been formulated, but need for continual improvement in drain management remains with us. We accept surgical instruments and supplies as standard items, giving little thought to the possibility of improvement and the manner in which improvement might be accomplished. The various types of drains in use today do not provide adequate security against loss. A drain may disappear into a wound or be broken off during removal. For the surgeon, there persists that perplexing postoperative question: Where is the drain? An error in judgment may result in the leaving of a drain within a surgical wound. The surgeon's prime concern is to be sure

To the Editor:— Will Dr. Touroff please accept my heartfelt apology for not having reviewed the literature sufficiently to have come upon his recommendation in 1931 in theAnnals of Surgery?I assure you that I am most embarrassed and I know that Dr. Flax undoubtedly feels the same embarrassment that I do. It would seem only natural, having come upon Dr. Beneventi's article in 1953, that we should assume his priority, but obviously we were in error.