The fact that deficient lacrimation may produce disturbances of the cornea and the conjunctiva has long been known (Wagenmann,1 1893). Comparatively recently (Fuchs,2 1919) it began to be suspected that the decrease in function of the lacrimal gland might be a manifestation of a systemic disturbance. In 1933 Sjögren's classic monograph3a appeared, and his name is given to the syndrome of keratoconjunctivitis sicca, laryngopharyngitis sicca and enlargement of the parotid gland. ETIOLOGY Sometimes the cause of the diminution in lacrimal secretion is obvious. Congenital absence of the lacrimal gland has been reported by Duke-Elder4 and others. Lisch5 reported deficient lacrimation in three generations of one family: Of 13 members examined, only 2 were free of the disease. Surgical removal of the gland has been found responsible for this condition by Wagenmann,1 Avižonis,6 P. Knapp7 and Engelking.8 In a case reported