This five-year survey of ear disease in a London population of 10,000 is considered to be a valid description of the incidence of ear disease presenting in a general practice community, since all patients were examined and diagnosed either by the author or by the district hospital Ear, Nose and Throat Department. The results agreed generally with the findings of the National Morbidity Surveys, but a more comprehensive range of ear disease is described. There is general agreement, between this and other surveys in the United Kingdom and the United States, that the most common ear diseases presenting in general practice populations are acute suppurative otitis media and impacted wax, followed by presbyacusis, secretory otitis media, chronic suppurative otitis media, vertigo and traumatic deafness due to noise, blast or head injury. However, the incidence of these and other diseases differs greatly in many countries throughout the world and some aetiological factors are suggested.

The evidence in this paper points to the continuing need for the investigation of the incidence and aetiology of some ear diseases in many parts of the world.

Traditional healers in Nigeria attempt to treat tonsillar infections either by performing unulectomy with a sickle knife or by digital rupture of the tonsil. These procedures result in various complications, including haemorrhage, septicaemia, cellulitis of the neck, peritonsillar and parapharyngeal abscess, upper airway obstruction, and pharyngo-larygocele with pneumothorax. These complications are illustrated with case reports. The danger of encouraging traditional healers to practise unsupervised and unscientific medicine is stressed.

This report records the occurrence of an irradiation induced fibrosarcoma of the lower lip which appears to be the first case documented in this site. The problems associated with the histopathological diagnosis of such lesions are discussed and the value of electonmicroscopical examination of spindle cell sarcomas stressed.