THE SURGICAL procedure of colostomy, like a great many other operative procedures, has been affected by constantly changing concepts and technics. The purpose of this report is to present some of the contrasting attitudes that have existed in regard to colostomy, and, in particular, to note the change in thought that has occurred since the time of World War I. The decade from 1939 to 1949, which period has shown the greatest number of cases in which colostomy was used, has been chosen as the interval for which the British and American literature would be reviewed. Observations regarding 4,939 cases in which colostomy or colostomy closure was performed are presented. Also, certain technical details regarding the proper formation of colostomies and the safest and most satisfactory methods of performing closures are discussed. An effort will be made to show how the facts made available through military experience during the recent