1909.] 



Hcem-agglutinins, etc., in the Blood. 



71 



Hmmolysins. 



Numerous additional observations have been made in regard to hiBmolysins, 

 and, as stated in the previous report, it is only comparatively rarely that a 

 well-marked haemolytic action is obtained. In those cases in which haemolysis 

 occurs haem-agglutination is always present, but the more marked the 

 haemolysis in certain instances the less marked the lueni-agglutination. In 

 some instances the haemolytic mixtures were put straight into ice for 1 hour, 

 and then into the water-bath at 37° C. for 1| hours. In the second report it 

 was stated that " the final results in all cases were similar," but in this series 

 of cases we have found that the effect of this method was to reduce the 

 haemolytic intensity of the mixture, while, in some cases, the hiemolytic action 

 was completely aboKshed. 



It was thought possible, by heating a serum at 60° C. for 15 to 20 minutes 

 and then fully complementing it with another serum, auto-hgemolysis might 

 be excited, but in no instance did this occur. 



Splenic Extract. — Further observations have been made in connection with 

 the hfemolytic action of splenic juice, but all results concerning that subject 

 in this report have been negative. In the case of acute miliary tuberculosis, 

 although the immune serum possessed a high degree of haemolytic action for 

 normal red cells, yet the splenic juice failed to act. A similar result was also 

 obtained in a fatal case of acute lobar pneumonia. On the other hand, it was 

 pointed out in the second report that the splenic extract obtained from a case 

 of diabetic coma completely haemolysed normal red cells and the auto-immune 

 red cells, while the immune serum was inert in the latter instance, and was 

 of very limited value in the former. 



Jaundice. — Attention has previously been drawn to a case of jaundice in 

 which auto-haemolysis occurred ; further observations, however, have failed to 

 record another example. Additional cases of jaundice from all possible 

 causes have been examined for the purpose of ascertaining whether the 

 presence of bile pigment in the blood serum favours iso-haemolysis, but no 

 direct connection can be traced. In those instances in which h;«niolysis has 

 occurred the cases have been almost entirely due to malignant growths. 



The Resistance of the Red Cells to W atcr containing Sodium Chloride of 



various Strengths. 



H. P. Hawkins and one of us (L. S. D.)* showed that the red cells in two cases 

 of congenital cholaemia were especially susceptible to the action of hypotonic 

 solutions of sodium chloride. These observations have since been confirmed' 



* 'The Quarterly Journal of Medicine,' January, 1909, vol. 2, No. 6, p. 165. 



