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attacks of uremia with as high as 20 lymphocytes per cubic millimeter of spinal fluid during each episode, cell counts were made in 62 consecutive cases of uremia. Patients with a history or findings of syphilis or with any condition that could result in pleocytosis were not included in the series. In the last 30 cases examination was also made for the presence of meningeal signs. In 58 of the 62 cases the uremia was due to renal disorders and in 4 to gastric hemorrhages with prerenal azotemia. The urea content of the blood was calculated from the urea nitrogen determined by the aeration-titration method. The urea value of the cerebrospinal fluid was similarly determined from specimens drawn at the same time as the blood in 29 cases.An increase in cells in the spinal fluid has been mentioned in isolated instances of uremia by various investigators. Chauffard 1 reported the case of a woman aged 60 with renal disease of three months' duration with uremia. Spinal puncture revealed 50 segmented granulocytes (polymorphonuclear leukocytes) per microscopic field in the fluid on the first day of the illness. Eight days later there were between 6 and 7 cells, and 28 days later, no cells. Lepine 2 found no increase of cells in the spinal fluid in 3 cases of uremia in which such data were given. The meninges were intensely reddened. Lepine stated the belief that the meninges in uremia could be involved in the same manner as the peri¬ cardium. Caussade and Willette 3 described a case of uremia with 100

ELEVATION of the total-protein content of the cerebrospinal fluid has been noted in several disorders of metabolism and in diseases in which the metabolism is disturbed. Thus, the protein value of the spinal fluid has been found increased in myxedema (Thompson and associates1), chronic nephritis (Lyttle and Rosen-berg2), uremia (Madonick, Berke, and Schiffer3), and Cushing's syndrome (Trethowan and Cobb 4). Although an increase in the protein content of the spinal fluid of diabetic patients with peripheral neuropathy has been reported fairly frequently (Root and Rogers,5 Jordan,6 Rundles,7 Epstein8), information regarding the protein concentration of the spinal fluid in diabetic patients without clinical neurologic involvement is meager. Mestrezat9 and Levinson 10 stated that the spinal-fluid protein value is normal. Lochelongue 11 found increased protein in the spinal fluid in diabetes mellitus. Eskuchen 12 indicated that there may be a slight increase in