The patient here reported presented multiple skeletal abnormalities indicating diffuse adverse influences brought to bear principally on the developing spinal column. The absence of two ribs on one side coincided with the absent halves of the thoracic vertebrae, thus indicating the "intimacy of the primordium of a rib and its corresponding vertebra"2. The clinical appearance of tapered lower extremities, as well as the unilateral clubfoot and rectal and urinary incontinence, coincided with the experience recorded in previous papers. The narrowed pelvis, flattened buttocks, and shortened intergluteal fold were natural sequelae of total absence of the saerum. Despite the extensive skeletal changes, this child was able to sit and walk, although walking was materially compromised by the rigid deformity of the left foot. At present, suitable conservative orthopaedic measures are again being directed toward correcting the recurrent and difficult foot deformity.