PLATES LXXXIX-XCIV)" MICROLITHIASIS alveolaris pulmonum " was the name given by Ludwig Puhr in 1933 to a remarkable case of pulmonary calcification in which the lungs were increased fourfold in weight and great numbers of the alveoli were occupied each by a laminated '' stone ", the radiograph having shown opaque lung fields with fine miliary peripheral opacities. These cases are extremely rare and so far as we can ascertain none has been reported before in the English language. We now present such a case. Case report Clinical hiatoryA housewife, aged 50, was quite well until twelve months before admission in Janusry 1945, when she developed pleurisy on the right side and was kept in bed for three months. Since then she had complained of a moderate degree of breathlessness on exertion, slight morning cough producing scanty sputum, and slight loss in weight. Otherwise she seemed to improve until three months before admission, when she experienced a fresh attack of pain in the right side of the chest. There was no history of rheumatic fever, chorea or any chest illness prior to admission. She had led a normal life and ww able to climb the steep hills of her home town without undue distress; she had never worked in industry, had had no significant illnesses, and was childless.On admission she was found to be a slim woman in good general condition. There was a slight mdar flush, no anzemia, no clubbing of the fingers, no dyspncea and no orthopnoea ; her weight was 7 stones. The respiratory movements were good and the percussion note was resonant over both lungs ; the breath-sounds were vesicular, with a few scattered rhonchi over both sides of the chest. Clinically the heart was not enlarged ; there was a loud mitral &st sound at the apex ; the pulse was 72-80 per minute and the blood pressure 128/80 ; there was no pyrexia nor signs of venom congestion.Laboratory investigations showed Hb. 14.8 g. per 100 c.c., R.B.C. 5-4 million, W.B.C. 13,800 (polymorphonuclears 41 per cent., lymphocytes 50 per cent., monocytes 5 per cent., eosinophils 2.5 per cent., basophils 1-5 per cent.). Wassermann and Kahn tests negative, E.S.R. (Westergren) 56 mm. in 1 hour. No tubercle bacilli nor fungi were found in the sputum. The urine was normal.$'luoroacopy showed very heavy opacity of the middle and lower zones of both lungs and mottling of the upper zones. The outlines of the right dome of the diaphragm and costophrenic sinus were obscured, and the outlines of the heart were not distinguishable. The appearances remained unchanged throughout the next five years. X-ray examination of the chest, carried out

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SUMMARY The glandular acid phosphatase in a series of thirty benign and two cases of malignant enlargement of the prostate was estimated. Wide variation was discovered and the malignant glands were found to contain much less enzyme than the benign. The same glands were stained for acid phosphatase by Gomori's method Acid phosphatase was demonstrated in all. The histology of these sections is described and illustrated. An explanation is submitted for the wide variation in the figures for the benign glands and for the low ones in malignant glands.

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Actinomvcosis is now so widely known as a patilological entity that the presentation of four hours). Four months after injury the fracture was united, but the sinus over the greater trochanter continued to discharge. Six months after injury the cavity was laid widely open under VOL. 33B, NO. 2, MAY 1951 221 FIG. 1 222 C. H. CULLEN AND M. E. SHARP THE JOURNAL OF BONE AND JOINT SURGERY general anaesthetic through a transverse incision. Several sequestra were removed. Actinomvces, UNITS OF PENICILLIN PER CC.