THE COLLAGEN DISEASES 



should be noted that other manifestations than that given 

 as primary diagnosis were present in this series. A positive 

 Coombs test was observed, for instance, in five instances 

 other than the four patients with haemolytic anaemia and/or 

 thrombocytopenia. 



{b) Gajdusek's auto-immune complement fixation test 



At the experimental level, our interests in Melbourne have 

 been largely confined to the application of this test (AICF) 

 to the sera of patients in this group. The reaction was de- 

 veloped more or less by accident, Gajdusek's primary objec- 

 tive being to explore the possibility of recognizing a specific 

 antigen of infectious hepatitis virus in livers of patients dying 

 from acute yellow atrophy after hepatitis. The first reactions 

 were obtained with convalescent sera from hepatitis cases 

 but control antigens showed immediately that the reaction 

 was obtainable with a variety of human organ extracts and 

 had nothing to do with viral antigens. The titres with con- 

 valescent sera and from most sera of patients with chronic 

 hepatitis were low, but as the range of sera tested was extended, 

 three sources of high titre reactivity were found. A propor- 

 tion of patients with (a) disseminated lupus erythematosus, 

 {b) chronic hepatic disease, especially of the types defined 

 by Saint et al. (1953) as chronic active hepatitis and by 

 Mackay, Taft and Cowling (1956) as lupoid hepatitis, 

 (c) macroglobulinaemia, gave titres measured in thousands. 

 Each group, however, gave only a small proportion of high 

 titre sera and all included sera which were completely nega- 

 tive in the test. 



Over the last year there has been extensive serological 

 study of these high titre sera and two findings may be 

 stressed particularly. 



(i) In the positive macroglobulinaemic sera the AICF 

 reagent is present in the macroglobulin fraction but 

 antibodies against herpes virus and staphylococcal 

 toxin also present are not contained in that fraction. 



137 



