In a series of 1,903 tuberculous patients admitted to the sanatorium during the past five years, there were twenty individuals in whom a fracture of one or more ribs occurred as a result of muscular violence associated with coughing. There was one instance among 1,194 incipient cases (0.08 per cent), twelve among 601 moderately advanced (2 per cent) and seven among 108 far advanced (6.5 per cent). Ten additional cases were discovered in our outpatient department, making a total of thirty. In no instance was there a history of direct trauma and this factor may be reasonably excluded at least in ten of the patients who were confined to bed at the time the fracture occurred. The incidence of fractures in this series leads me to agree with the view expressed by Stimson1some fifty years ago: "Fractures of one or more ribs are not infrequently caused by violent