the lavage in our patient, but this may reflect the severity of the pulmonary function impairment. With the use of the irrigation system described here effective lavaging was accomplished. One cannot say with certainty what amount of benefit our patient derived from pulmonary lavage: Certainly her dependence on oxygen decreased, at least temporarily, and her physical findings were initially significantly improved. It is possible that had she been lavaged earlier in the course of her disease, the marked obstructive changes she developed might have been partially obviated. The two male siblings with alveolar proteinosis, now aged five and four years, respectively, who were reported by Seard and associates, ~ had onset of symptoms at 10 months and 3 months of age, respectively. Pulmonary lavage was performed on each at age 3 and 2 years, respectively. The single lavage performed on the older child seemed to be long lasting in effect. The younger sibling became progressively more dyspneic and was Iavaged a second time, after which he required only low concentrations of oxygen. Physicians caring for these children believe that the older child no longer has an increased need for oxygen, but the sibling interplay is such that as long as his brother requires oxygen, he insists on having it