K. LANDSTEINER 



901 



— recorded in the literature (e.g., linger)' fall under this head. Whether or not this 

 holds for all such cases cannot be stated definitely since most often the effect of changes 

 in temperature is not recorded. That there are transitions between the "cold" and the 

 other agglutinins follows from the fact that heteroagglutinins and probably common 

 isoagglutinins contain fractions similar to cold agglutinins which can be demonstrated 

 by suitable absorption experiments^ (see below). 



MARKED ANOMALOUS REACTIONS 



Anomalous reactions comparable in intensity to that of atypical isoagglutination 

 are met with only rarely in the usual tests. Most of the published observations are not 

 sufficiently studied to permit of a critical analysis. In all such cases it would be nec- 

 essary to make cross-tests on an extensive scale with the corpuscles and the sera; the 



TABLE IV* 

 Absorptions and Readings at 0° C. 



*The figures signify individual bloods. 



Strength of the reactions and influence of temperature variations should be deter- 

 mined and the method given in detail. 



Two fully examined instances are the following: The writer and Witt described 

 two bloods belonging to group AB with cells lacking the property A', the sera of which 

 contained agglutinins of the type a\ thus acting on a number of bloods of group A, 

 namely, those corresponding to the formula AA^ The sensitiveness of the reaction 

 to an increase in temperature was intermediate between cold and common agglutina- 

 tion. In other bloods of group AB, also lacking A', either no agglutinins a' were found 

 or such as behaved like cold agglutinins. The two atypical cases would correspond 

 to a formula AB, a.' Another indubitable case of an intense anomalous reaction was 

 described by Ottenberg and Johnson. -'* The blood of a professional donor according 

 to the properties of the cells belonged to group B ; the serum contained the agglutinin 

 a as usual but in addition an abnormal agglutinin which reacted on a number of cor- 

 puscles of groups O and B. Transfusion of this blood into an anemic patient was fol- 

 lowed by a grave, presumably fatal, hemolytic accident. An apparently similar in- 

 stance was noted by Beck.'' Examples of doubtful or incomplete observations are the 



' Unger, L. J.: J. A.M. A., 76, 9. 192 1. 



^Amzel, R., and Hirszfeld, L.: Ztschr. f. Immunitdlsforsch. u. exper. Therap., 43, 526. 1925; 

 Landsteiner, K., and Levine, P.: loc. cit. 



3 Ottenberg, R., and Johnson, A. X.: J. Immun ., 12, 35. 1926. 

 '' Beck, A.: Ergcbn. d. inn. Med. u. Kindcrh., 30. 150. 1926. 



