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Scientific Proceedings (129) 



be chilled to 12° C, or even 8° C. It is not unlikely, therefore, 

 that in the spontaneous paroxysm, the same mechanism operates 

 as in the test tube reaction. 



Yorke and Macfie 1 recently reported that hemolysis is greater 

 if the erythrocyte-hemolysin-complement mixture is chilled only 

 5 to 7 minutes, rather than 30 to 60 minutes. We have con- 

 firmed this observation. Their explanation of this somewhat 

 paradoxical phenomenon is that, with longer exposures at the 

 low temperature, the complement is distributed among a larger 

 number of sensitized cells with the result that each cell has less 

 complement, and some cells have ineffective quantities. That 

 this explanation is not entirely satisfactory is evident from the 

 following experiment. To graded red cell suspensions from 0.5 

 per cent, to 50 per cent, constant amounts of serum and comple- 

 ment are added. The mixtures are chilled and then warmed 

 in the usual manner. It is found that the amount of hemolysis 

 increases with the percentage of the cell suspension, and that 

 suspensions of 0.5 per cent, and 1.0 per cent, showed no hemo- 

 lysis. With heavier suspensions there would presumably be a 

 distribution of complement among a larger number of cells, and 

 yet there is more hemolysis in the heavy suspensions. It there- 

 fore seems unlikely that the explanation of Yorke and Macfie 

 for the greater hemolytic effect of short chilling is correct. 



One of the interesting questions in paroxysmal hemoglobin- 

 uria is the relation of this condition to syphilis. About 90 per 

 cent, of these patients as reported in the literature have had a 

 positive Wasserman reaction. Many of them have been con- 

 genital syphilitics; others have had lesions of acquired syphilis, 

 and some have had only serological evidence of syphilis. One 

 of our three cases is a congenital syphilitic; another probably 

 has syphilis of the liver, and the third has a history of syphilis 

 but no demonstrable lesions at present. All three have positive 

 Wasserman reactions, and it is of interest that the reaction in 

 two of the three cases is extraordinarily strong. The highest 

 titre was found in the congenital syphilitic, a girl of 11, whose 

 Wasserman titration at .001 c.c. was: alcoholic antigen + 

 cholesterin antigen + + + + , larger quantities gave + + + + re- 

 actions with both antigens. The Landsteiner reaction was found 



I Yorke, W., and Macfie, J. W. B., Brit. J. of Exp. Path., 1921, ii, 115. 



