Idiopathic ulcerative colitis lends itself particularly well to discussion before a combined meeting such as this. Its problems present a real challenge to internist and surgeon, for only through the understanding and well coordinated efforts of both can the patient be assured of a quality of care likely to succeed. It is not our purpose today to outline details of clinical diagnosis or technical management; we wish instead to emphasize the principles followed in surgical care and the indications for the several operations used. From a study of the postoperative results in the group of patients who have been under our personal care and under the care of those associated with us in this assignment at the Massachusetts General Hospital,1we have attempted to determine just what adjustment the patient with an ileostomy can make to the social and economic problems presented to him. At the present time, there