have seen a great increase in the use of endotracheal intubation, which has enhanced both the safety and the smoothness of anesthesia. Despite the undoubted advantages of this technique, the dangers, however rare, which accompany it should not be underestimated. These, for the most part, are connected with the reaction of the mucous membrane of the upper respiratory tract. Since 1932, when Clausen1 described the first case of laryngeal granuloma following intubation, the number of cases reported has risen steadily, but relatively little has been written on other complications. It is probable that this scarcely reflects an accurate picture of the complications which do, in fact, occur. Flagg's survey,2 in which he received responses from 154 laryngologists, 99 of whom were called for consultation because of injury to larynx or trachea following endotracheal intubation for anesthesia, supports this belief; 34 of these reported a total of 101 granulomas. Other special injuries mentioned were paralysis, hemorrhage, and lacerations of the vocal cords ; laryngotracheal edema ; leucocytic mem¬ brane of cord and trachea ; tracheal webs, and perforation of the trachea. In this connection we present the following five cases in which symptoms were so severe that relief could be obtained only after bronchoscopy or tracheotomy. REPORT OF CASES Case 1.—F. C, a woman of 45, had a nephrectomy performed on Dec. 21, 1952. Premedica¬ tion was morphine sulfate, 0.01 gm., and atropine, 0.0005 gm., given an hour before operation, which lasted for two and a quarter hours. Induction was with pentothal, and the throat was sprayed with 2% tetracaine (Pontocaine) hydrochloride and cocaine before intubation, which was fairly difficult. The patient was placed on her left side and anesthesia maintained with nitrous oxide-oxygen-ether. Twelve milligrams of tubocurarine was given during the operation. The next day there was marked difficulty in breathing, accompanied by stridor. Indirect laryngoscopy showed a normal epiglottis ; the area around both arytenoids was only slightly swollen, and ulceration had occurred on the right with the formation of a whitish fibrinous deposit. There was marginal erosion of both vocal cords, while in the subglottic region a whitish gelatinous membrane almost obstructed the lumen, leaving only a tiny gap. Tracheotomy was performed, with immediate relief of symptoms, but the patient's eventual recovery was further complicated by a small pulmonary infarct on the right side.