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greatest tolerance for galactose as measured in the newborn period seemed to have the fewest speech and language difficulties. Moreover, a str iking similari ty in language and motor disabilities was noted in the siblings with galactosemia, despite the fact tha t the younger child in each pair had never been exposed to a postnatal accumulat ion of galactose-l-phosphate and had not been sick in the newborn period. Thus the damage does not seem to have originated solely from the postnatal accumula t ion of galactose-l-phosphate; this finding supports the possibility of a prenatal effect.

Summary In a white American family with no evidence of Negro or Mediterranean ancestry, two children, aged one and three and one-half years, suffered from sickle-cell anemia since early infancy. Their father had sicklemia without anemia. In all the sickling was of the slow type, which requires from twelve to twenty-four hours to appear. Both children were stunted in growth, the girl being more dwarfed than her baby brother. The removal of an enlarged spleen in the younger child failed to affect the anemia or the sickling, while the spleen in the other patient was small. The noteworthy features in these cases, in addition to their ethnologic interest, concerns the early age at which symptoms of anemia appeared in both children and the slow type of sickling. It is suggested that even in anemia of white American children, the possibility of sickle-cell anemia should be remembered and a moist blood film examined after kept twenty-four hours.