I MAKE no apology for offering a paper under this title. More papers have been written on this subject than on any other in otology. The importance of the subject is paramount. From the time of Hippocrates chronic purulent otitis media has been a disabling, crippling, disgusting and death-dealing disease. It has been the despair of otologists throughout the ages. This is not to say that otologists have not obtained cures in a large percentage of patients, but it is to say that in spite of the most meticulous care there has always been a percentage, at least 20, that have been given up as incurable and so advised by conscientious otologists. INCIDENCE The number of cases of chronic purulent otitis media in the world today is truly appalling. Arthur Cheatle examined 1,000 school children in England and found 88 cases, 8.8 per cent.1Among the 2,074 school children of