208 



Mr. L. S. Dudgeon. On the Presence of [Feb. 18. 



out of the entire number investigated that the phagocytosis was well marked. 

 In the majority of instances the experiments on haemolysis led to negative 

 results. In one case of acute poisoning, of unknown nature, physiological 

 salt solution (0'85-per-cent. pure sodium chloride) was found to be able to 

 haemolyse the immune red cells. In two cases of pneumonia evidence of 

 haemolysis was tested for in the blood examined in vitro. In one instance 

 well-marked auto-haemolysis occurred, in the other iso-haemolysis. Some 

 degree of iso-haemolysis was noted occasionally in the experiments with the 

 blood obtained from other diseases, and in one further case auto-haemolysis. 



In the present communication many more interesting results have been 

 obtained in various experiments conducted along the same lines and much 

 more additional information acquired. It will be necessary at the commence- 

 ment to give a list of the various diseases that have been investigated, and to 

 point out that exactly the same care has been exercised in proving the 

 accuracy of the diagnosis. 



14 cases of typhoid fever ; 9 cases of tuberculosis (mostly acute pulmonary) • 

 3 cases of acute peritonitis clue to appendicitis ; 14 cases of anaemia (7 of 

 pernicious anaemia), myelaemia, congenital cholaemia, and examples of anaemia 

 secondary to various well recognised conditions ; 7 cases of acute pneumonia ; 

 6 cases of acute streptococcus infection ; 2 cases of epilepsy ; 4 cases of syphilis ; 

 2 cases of diabetic coma ; 3 cases of malignant disease ; 5 cases of obscure 

 toxaemia, including one case of paroxysmal haemoglobinuria. 



Hcemolysins. 



The technique adopted was exactly that already referred to in the pre- 

 liminary report, with the additional observations obtained by allowing the 

 mixture of serum and red cells to be in contact in ice for 1 hour previous to 

 incubation at 37° C. for a similar period, followed by exposure to ice for 

 several hours. These final results in all cases were similar, so that this 

 method was abandoned. 



In the previous paper, the following conclusion was arrived at : — " In all 

 these experiments on haemolysis, it was only occasionally that the hemolytic 

 action was distinctly shown ; in the majority of instances no haemolysis 

 occurred." 



Typhoid Fever. — Xo haemolysis was noted in any of the cases of typhoid 

 fever which were examined. The results obtained in this disease, as in many 

 others, were probably due to the fact that normal serum was only occasionally 

 employed in these experiments. Out of the total number of cases investi- 

 gated in the present series — 14 — haemolysis was demonstrated in nine 

 instances — a very high proportion. 



