The mortality rate, so far as I have been able to determine, is 100 per cent in congenital atresia of the esophagus. Death is not due to starvation in most cases, but to pulmonary complications from the aspiration of secretions and from the return of fluids and foods when a gastrostomy has been done through the lower segment of the esophagus. The usual method of diagnosis is the administration of a bismuth preparation or barium sulphate with roentgen study. This outlines the pouch, and if the upper segment of the esophagus communicates with the trachea, the mixture passes into the tracheobronchial tree. If there is no communication between the upper segment of the esophagus and the trachea, unless great care is exercised there will be an overflow and secretions will be aspirated into the trachea, in many cases contributing largely to the pulmonary complication. A female infant 3 days of