The entire controversy concerning the incidence of mahgnant degeneration in achalasia cardia can squarely be put on the shoulders of the late Dr. Fagge of Hythe in Kent who in 1872 suggested that an epithelioma that he as a pathologist diagnosed in a patient of his father’s, was a recent development in an esophagus with longstanding narrowing of the cardiac end [1]. Dr. Fagge did not even say one caused the other, but merely drew attention to the association of one with the other. Over the past 115 years, an increasing array of pubhshed papers has accumulated “evidence” that wih lend itself to continued discussion by chnicians, pathologists, epidemiologists and statisticians for a true appraisal of the “incidence” of carcinoma of the esophagus in achalasia cardia.