To the Editor: Romanul et al. (296:1505–1508, 1977) described another family descendant from immigrants from the island of São Miguel and afflicted with a genetic progressive neurologic disorder. They compared their findings to those previously reported in three families of similar ancestry, with the thesis that all these families represent a single genetic entity with variable expression.1 2 3 In June, 1977, I conducted a field trip throughout the Azores Islands to determine the epidemiologic status of the form of Joseph's disease that we described in August, 1976,3 and to investigate any variability in its clinical expression. I examined the Machado.
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