noted. The spleen reached one finger's breadth below the costal margin. The neurologic examination was normal.
Laboratory studies revealed hemoglobin to be 8 Gm. per 100 cc. Leukocyte count was 1,500 per cubic millimeter; in the differential count, neutrophils were 51 per cent, lymphocytes 36 per cent and monocytes 13 per cent. The plasma lupus erythematosus test1 gave positive results. The sedimentation rate (RourkeErnstene) was 0.75 mm. per minute (the normal being less than 0.45). There were no total blood eosinophils.2 Blood chemistry determinations (urea, sugar, serum sodium, potassium, plasma carbon dioxide-combining power and chlorides) were normal. Plasma proteins (electrophoretic technic) totaled 5.97 Gm. per 100 cc., albumin 2.69 Gm., alpha globulin 0.55 Gm., beta globulin 1.22 Gm., gamma globulin 1.18 Gm. and fibrinogen 0.3 Gm. per 100 cc. Urea clearance was 68 per cent of normal. A 12 hour urine specimen taken at night contained protein 1.05