We have described the use of the simple laboratory star-tracing test in assessing the course of the alcohol withdrawal syndrome. Test scores (number of line irregularities) correlated best with clinical estimates of tremulousness (Spearman rho = 0.61) and also correlated with the over-all course of the syndrome as measured by total scores computed from a nurses' clinical rating form. Apart from the basic physiological disturbance, it appears that the other 'main influence on test scores is variation in emotional disturbance. It is concluded that such a performance measure should be a useful objective adjunct in evaluation of treatment of the alcohol withdrawal syndrome.In preparation for carrying out controlled studies of the use of drugs in the alcohol withdrawal syndrome, we wished to develop an objective technique to be used in following the course of the syndrome. W e also required of such a test that it be simple, usable at the bedside and inexpensive, so that others in clinical settings might easily take u p its use.In initial studies we assessed the hundred-minus-seven serial subtraction tesc and found it of no use; performance was most dependent upon the patient's motivation and level of native intelligence, and scores correlated very poorly with the course of improvement. W e then directed our attention to a simple %pointed star-tracing test (Fig. l ) , as described below. Time taken for the patient to complete a tracing as a speed tesc and the number of errors (tracing outside the track) were not found to be useful measures for our purpose. However, the number of line irregularities appearing in the tracing did seem related to the clinical course. In a preliminary group of 9 alcoholics showing withdrawal symp toms initial tracings showed 15 to 35 irregularities per half star and at time of discharge had leveled off at 12 or fewer per half star.A group of 9 female hospital employees of above average intelligence on repeated testing had 6 or fewer irregularities per half star, and 7 medical patients and 13 non-alcoholic psychiatric inpatients scored in a range of less than 12, except for one tremulous patient with an agitated depression who had a high score. As with the alcoholics, the normals and other patients did serial star-tracings both repeated on the same day and on si~ccessive days. There was very little vari-'This investigation was supported by the Alcoholism Foundation of Manitoba. 'Associare Professor, D e p a m e n c