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 request for information and the pains he took to procure it for us. His Lordship was, however, unable to gain the consent of those to whom he applied to help in any way in supplying an answer to a very simple question. As the matter is one of general interest not only to the medical profession but to the whole of mankind, we think it right to give the true facts of the case, of course without disclosing the patient's identity.

'The operator was Mr. Butlin, who has been good enough to give us permission to publish the following account. He saw the patient, who was at that time thirty-seven years of age, in 1890. There was then a very white patch, flat and sessile, on the middle of the left vocal cord, looking like a papillary growth. A month later the surface seemed to be ulcerated. The patient was seen by other well-known specialists, who, like Mr. Butlin himself, were puzzled as to the nature of the disease. Tubercle, papillary growth and malignant