Absorption of gold from injected sites occurs rapidly, reaching its peak in blood between 4 and 6 hours. In plasma, 95% of gold is bound to albumin. Three patients that were studied from the beginning of weekly therapy showed a progressive stepwise rise in plasma gold levels up to the sixth week. Urinary excretion was greatest during the first day postinjection while fecal excretion was greatest during the middle of the week. The blood levels, as well as excretion, varied from patient to patient. Patients on maintenance therapy excreted 39,16,12 and 10% of the injected dose in the first, second, third and fourth weeks postinjection, respectively. There were no significant differences in blood gold levels in patients who showed a good therapeutic response, no therapeutic benefit or toxicity.Gold salts have been used for the treatment of rheumatoid arthritis for 40 years. Interest in this form of therapy was stimulated by Forestier (1) in 1929, who stated "the mode of action of aurotherapy in chronic rheumatism cannot

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Arthritis of the cricoarytenoid joint OCcurs much more frequently in patients with rheumatoid disease than has generally been suspected. Seventeen of 64 randomly selected patients with rheumatoid arthritis had one or more symptoms considered to be characteristic of cricoarytenoid arthritis. At postmortem examination, histopathologic changes typical of rheumatoid arthritis were seen in the cricoarytenoid joints in seven of eight patients with rheumatoid arthritis. The abnormal findings on indirect laryngoscopy, typical of rheumatoid arthritis of the cricoarytenoid joints, are reported and treatment is discussed. HE CRICOARYTENOID JOINT is more frequently involved in rheuma-T toid arthritis than is generally suspected. The importance of this joint in phonation and respiration accounts for reports predominately in the otolaryngologic literature dealing with various types of cricoarytenoid arthritis.2-'b The following clinicopathologic study was undertaken to determine the frequency, severity, and types of changes in this joint found in patients with rheumatoid arthritis.The anatomic features of the cricoarytenoid joint help explain the signs and symptoms encountered. The cricoarytenoid joint is diarthrodia1,l with a ligamentous capsule lined by synovial membrane. Muscles act on the joint to adduct and abduct the vocal cords. Two types of movement occur during normal phonation and respiration: 1 ) rotation of the arytenoid on a vertical axis, which allows the vocal process to move laterally and medially, thereby increasing and decreasing the glottic space; and 2 ) a gliding movement by which the arytenoid cartilages approach and recede from each other. Gliding and rotation are intimately integrated-medial gliding with medial rotation and lateral gliding with lateral rotation. METHOD OF STUDYThe clinical features of cricoarytenoid arthritis were studied in two groups of patients with rheumatoid arthritis attending the rheumatic diseases clinic