Having accumulated a very large series of patients' records over a period of 60 years, some involving three generations of a family, the author has selected cases that illustrate the opportunities to observe the progress of patients from infancy for more than half a century. This unique opportunity has included a variety of clinical conditions such as congenital syphilis, cretinism, acute osteomyelitis, and pink disease and represents a long term follow-up of conditions which reflect both the paediatrics of the past and the changes in the pattern of disease which have occurred in the course of 60 years.