I want to emphasize again the point Dr. Churchill brought out about the psychologic handicap to the surgeon in the cases in which one has the typical bone picture but not the typical blood chemical findings. After one has searched for two hours unsuccessfully, in an atypical case, there is a doubt in one's mind whether to go on and subject the patient to any more search.Dr. Lahey called me the day before yesterday to say he was sorry he could not come to discuss the paper. He told me that he had just operated on a patient who, he was absolutely convinced, had a parathyroid adenoma, but that he had failed to find the tumor. Previously three excellent surgeons had explored the neck without success. This emphasizes the fact that it is an extremely difficult thing to find the parathyroid glands, even when one is positive that a tumor is present.EACH of the recent developments in the field of chemotherapy has been followed by a flood of confusing reports and claims. Sulfamethylthiazole and sulfathiazole have been no exception. A survey of the literature shows consistently good results obtained in staphylococcal infections.Bactériologie experiments conducted by Rake and McKee1 have shown sulfamethylthiazole and sulfathiazole to be particularly effective. This is further substantiated in a report by Krock and Chamberlain.2 Many different types of staphylococcal infections have been successfully treated with these drugs. Grulee and Mason3 report excellent results in cases of furunculosis in children. Fitch4 obtained noteworthy results in a case of epidural abscess with septicemia and pyemia due to Staphylococcus aureus. Another case of staphylococcal septicemia, with excellent end results following the use of sulfamethylthiazole, is reported by Carroll et al.5 In a study of the literature one is immediately aware of the many toxic effects of these drugs.Pepper and Horack6 report the formation of concretions in the renal tubules following sulfathiazole therapy. Knoll and Cooper7 also report clinical urolithiasis due to sulfathiazole. Haviland and Long8 report conjunctival and scierai reactions in the course of such therapy. Further study of these reports reveals that the aged are more susceptible to these toxic effects than patients in the younger age groups.