It has been suggested that auto-antibodies are concerned in the pathogenesis of many diseases. These autoantibodies develop against various tissues, the cells of which have been made auto-antigenic by being altered by the action of toxins, chemical and physical agents or by the presence of intracellular parasites. It is difficult to detect auto-antibodies against tissue cells. Auto-antibodies against red cells can be detected directly by determining whether auto-agglutinins or isoagglutinins are present in the patients' serum or by the application of the Coombs test or other tests for detecting the sensitization of red cells by immune globulin. It was considered possible that auto-antibodies to various tissue cells might involve the red cells as well as the tissue cells primarily affected. Accordingly the blood of patients with various conditions has been systematically tested for sensitization of red cells. It was found that the majority of cases of syphilis gave a positive Coombs test but most cases of other acute and chronic infective diseases gave negative results. Most cases of acquired acholuric jaundice, acute rheumatic fever, acute disseminated lupus erythematosus also gave positive results in the Coombs test. These findings suggest that auto-antibodies may be concerned in the pathogenesis of these diseases. Three cases of subacute pneumonitis, two of which ended fatally, also gave a positive result in the Coombs test. This suggests that this condition, which apparently is a clinical entity not descriptionbed before, has an auto-allergic basis. It is noted that the administration of ACTH and Cortisone is probably harmful in infective diseases unless the infection can be controlled by the prior or simultaneous giving of drugs or antibiotics which can control the infection. On the other hand the administration of these hormones is beneficial in the hypersensitivity and autoallergic diseases. It is therefore important to distinguish clearly between the infective diseases and the hypersensitivity states.
Nineteen cases of Mediterranean anaemia in a single family are descriptionbed. On clinical, haematological and radiological grounds they fall clearly into three groups: Group I: Cases showing well-marked hypochromia, icterus, spenomegaly, normoblasts in the peripheral blood, and an elevated reticulocyte count. The bone marrow showed marked normoblastic hyperplasia, and radiological changes were present. The females in this group showed chronic ulceration over the malleoli. Group II: Cases showing hypochromia, either low or normal haemoglobin values, but usually high red cell counts (6-7 million cells per c.mm.), and no icterus. The bone marrow may show a moderate degree of normoblastic hyperplasia. Group III: Cases showing evidence of the trait, viz. the red cells have an increased resistance to saline haemolysis. Target cells are present in the peripheral blood. The pathogenesis of the condition is discussed.