My first acquaintance with congenital cystic kidney was gained in the dissecting-room of the Boston City Hospital, where I saw several necropsies on patients of middle and adult life who had come into the hospital in convulsions and died of uremia. In some of them, the enlargement of the kidneys had been noticed before death; in others, not, but at the necropsy the kidneys were found very much enlarged and studded with numerous cysts ranging in size from a pea to an orange. These cysts were yellow, green, red and brown, and the effect was very beautiful, making a pathologic specimen truly remarkable and imposing in appearance. These necropsy cases were bilateral, one kidney being considerably more enlarged than the other. Cases in which gradual enlargement of a polycystic character takes place in middle life, and in which the patients present themselves to the surgeon on account of dragging pain