In early 1966 one of our Down’s syndrome patients, James Bair, who had originally been negative, was found to have Au on a second test. Since this was an aberrant finding we admitted James to the Unit. There was no obvious change in his clinical status. Because he apparently had developed a "new" protein, and since many proteins are produced in the liver we did a series of "liver chemistry" tests. These showed that between the first testing (negative for Au) and the subsequent testing (positive for Au) James had developed a form of chronic anicteric hepatitis. On 6/28/66, the day of his admission to the Clinical Research Unit, my colleague, Alton I. Sutnick, wrote the following dramatic note in the patient’s Chart (see slide) His prediction proved correct. The diagnosis of hepatitis was clinically confirmed by liver biopsy on 7/20/66, and we now began to test the hypothesis that Au was associated with hepatitis.