When perforation occurs after endoscopy, provided the endoscopist is confident that it has not resulted in the region of a pre-existing lesion, it is almost certainly in the post-cricoid area. As soon as the diagnosis is made the perforation should be exposed and sutured. Delay must lead to an increase in the friability of the oesophageal wall with a consequent likelihood of the stitches cutting out, as occurred in the case descriptionbed.
*Formerly Medical Officer, Transvaal Bilharzia Committee. Abstracted and re-written from a portion of a thesis presented to the University of Pretoria for the degree of Doctor of Medicine, December 1948. The incidence of Bilharzia haematobium in the Transvaal, based on 15,000 urine examinations, is given. A preliminary investigation into the incidence of Bilharzia mansoni, using rectal biopsy technique, is reported. Other methods of diagnosis are briefly discussed.