Dr. SEQUEIRA showed a case of _Lupus vulgaris_ to illustrate the value of Dr. A. E. Wright’s recent work upon opsonins. The patient, a Jewess, aged 20 years, was first seen at the London Hospital in the summer of 1900. The whole of the face and part of the neck were then much infiltrated and in parts ulcerated. The feet also were affected, parts of several toes having been destroyed. Owing probably to the fact that she was unable to walk, the patient was not seen again until February, 1905. Fortunately, photographs of the condition in 1900 were preserved, and these showed that the disease had extended very little in the four years and a half, although the patient had had no treatment whatever in the interval. The general health had improved, but the lupoid infiltration of the face and neck were well marked and there was still considerable ulceration, the ulcers being covered with dirty scab. The destructive ulceration of the toes had slightly increased. There were no physical signs pointing to tuberculosis of the internal organs. The glands were slightly enlarged, but this was not a marked feature. Dr. Sequeira took the patient into the hospital, intending to use tuberculin. Before doing this, the blood was examined by Dr. Wm. Bulloch, who found that the opsonic index was 1·3, normal blood being 1. A high opsonic index, it may be mentioned, has been found by Dr. Bulloch in a certain proportion of the cases of Lupus attending the London Hospital, and particularly in the chronic cases doing well under the light treatment. As the opsonic index was already high in this case, it was deemed unnecessary to raise it by the injection of tuberculin, and fomentations were applied to the affected areas, to bring the opsonins to the diseased parts. The result was very striking. In a few days the lesions were paler, flatter, and clean. When shown at the meeting, after a fortnight’s treatment with fomentations, the infiltration had markedly diminished, the raised margin being flatter and paler, and the ulcerated areas healed up, except upon the stumps of the toes. The fomentations were of boracic lint soaked in hot water and covered with oil silk frequently changed. It may be mentioned that the improvement was much more rapid than had been seen in similarly extensive cases treated by fomentations, the only known difference being the high opsonic index. The case is of importance as supporting Wright’s work, and also as showing the value of examining the blood before injecting tuberculin. It also explains why some apparently severe cases do well under simple treatment. Dr. GRAHAM LITTLE was able to confirm Dr. Sequeira’s observations in this case from one at St. Mary’s Hospital, in which a similar improvement had been noticed with fomentations in a patient whose opsonic index was as high as 2. * * * * *