This highly effective fully ambulatory outpatient regimen deserves further testing in randomized trials both in chemotherapy-naive patients and before surgery to remove metastases.

EDITORIAL SYNOPSIS The authors present evidence to show that a long colon is associated with constipation. In certain cases of intractable constipation associated with a long colon they recommend surgical treatment.It is well known that megacolon may cause chronic constipation. On the other hand, the significance in this respect of another anomaly of the colon, namely, a long, or redundant, colon (dolichocolon), is not as clear. The excess length of a redundant colon is usually greatest in the distal colon, the most common variety being an enlarged sigmoid loop (Kantor, 1931). In contradistinction to the megacolon, dilatation of the lengthened portion and thickening of its wall are lacking in the redundant colon.The concept of redundant colon was introduced into the literature by Kantor (1931). He found this anomaly in 343 (18.5 %) of 1,850 patients examined radiologically. The abdominal symptoms, which were more common in the patients with redundant colon than in his series in general, were constipation and distress caused by gas. Constipation was present in 66% of patients with redundant colon and in 46% of the whole series; the incidence of distress due to gas was 70 and 38 % repectively. The incidence of redundant colon was approximately the same as the above in the necropsy series of Bryant (1924), among whose 242 examined subjects a redundant colon was encountered in 14 %. The somewhat higher incidence of 29% was seen in 100 patients with various types of colonic dysfunction reported by Bockus and Willard (1934).There is no reference in the literature to the incidence of redundant colon in patients with constipation as compared with the incidence in persons without this symptom. However, on the basis of the figures reported by Kantor (1931) it can be calculated that 24 % of patients with constipation and 13% of patients without constipation had a redundant colon.For over 25 years, interest in the clinical importance of the redundant colon has been slight. Since the data presented above indicate that it is of some significance as one of the causes of chronic constipation, we have once more studied this question on

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The significance of achlorhydria for the etiology of iron-deficiency anemia is a problem which is closely related to the significance of the gastric acid secretion for the ahsorption of iron. Hydrochloric acid plays an important part for the following reasons: 1) Iron is more readily absorbed from an acid than from an alkaline medium 2) Hydrochloric acid facilitates the conversion of ferric to ferrous salts which 3) Hydrochloric acid makes possible the digestion of food by pepsin and thusNormally iron is chiefly absorbed in the intestines and particularly in the upper part. I t is not absorbed in significant amounts from the stomach unless the food remains there for some t h e (about 4 hours according to Delhougne, 1931). This is easy to understand if we remember that in most people the pepsin digestion hardly has time t o liberate iron from the foodstuffs in any considerable amount. It is therefore clear that the beneficial effect of the acidity of the gastric content on the absorption of iron from fhe stomach cannot be significant when compared with the total absorption of iron. Similarly hydrochloric acid can in the stomach contribute only little to the conversion of the ferric into the ferrous salts and is probably quite insignificant for the total iron absorption. In the small intestine the hydrochloric acid which is already neutralized takes no part in this process and the conversion which takes place here is due to substances which (Mettier and Minot, 1931). appears to be the only form in which iron is absorbed.indirectly facilitates the liberation of iron from the food.