My attention was first directed to this condition by Makuen of Philadelphia, who exhibited a similar case before the College of Physicians and Surgeons about a year ago. As far as I have been able to discover, there has been no reference made to it in medical literature up to the present time.
—L. C., white, female, single, aged 18, referred to me by Dr. Mary Townsend, of this city, consulted me Oct. 22, 1908. Practically her entire complaint was a marked defect in speech, which she said had existed ever since she began to talk; it was that alone which prompted her to seek medical advice. There was slight nasal obstruction and some postnasal "dropping," but these were not troublesome enough to cause any complaint in themselves. There was no history of diphtheria or other serious illness; in fact, with the exception of measles at the age of