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The literature is discussed in 19 pages. A short chapter delineates the subdivisions of otitis media in children, the pathogenesis, and the relation to disorders of nutrition. An acute form is distinguished with various stages, as in older children or adults, from a form poor in symptoms or without clinical symptoms for which the designation "occult" is preferred. The main part deals with the clinic of otogenous disorders of nutrition under the headings of otitis media purulenta acuta and otitis media occulta, manifest mastoiditis, and occult mastoiditis. About 22 pages are devoted to the occult mastoiditis. Some of these are characterized by acute intoxication recognized at present as consequence of an occult mastoiditis. Others lead to chronic nutritional disorders as dystrophy and atrophy (athrepsia) without signs of intoxication referable to occult involvement of the ear. This causal relationship is still being contested. The single symptoms prompting the diagnosis of occult