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Last year 1 we reported a rare case of congenital edema which presented unusual features with reference to the lymphatic system. In this report we mentioned certain characteristics which clearly defined this type of edema as an entity different in many respects from congenital elephantiasis, further emphasized by a review of the literature.A few months after publication of this report, the child developed an acute infection which in a short time terminated fatally. Necropsy was performed, which brought to light some unusual and interesting pathologic conditions. However, before describing in detail the necropsy observations, we shall present a brief r\l=e'\sum\l=e'\of the clinical features as embodied in our previous article. CASE REPORTHistory.\p=m-\H.B., a white girl, born June 10, 1923, presented the following picture: (1) a markedly edematous left foot, leg and thigh; (2) edema of the left labium majus and the right shoulder, arm, hand and fingers; (3) a complete macroglossia with edema of the right lower lip, with a sharp line of demarcation at the center, and (4) edema of the right ear, the right upper and lower lids and enlargement of the right axillary lymph nodes. The general appearance was one of gigantism or elephantiasis. The affected areas were of firm consistency with slight pitting, and the right hand presented an extreme degree of puffiness, with a sharp crease marking the wrist line. The tongue practically filled the mouth. The left side of the face, the left shoulder, arm, hand and fingers were normal in appearance.

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The question of transference of antibodies, protein sensitization and infection, from mother to child has been studied much. Numerous investigators at various times have worked intensively on this subject.The most easily proved transference of immune bodies occurs in the case of the well known immunity to diphtheria, which is present in a high percentage of new-born infants. This may be investigated either by examination of the cord blood serum, or by the intradermal toxin test (Schick test).The most intensive studies on the diphtheria antitoxin content in mother and new-born that we have been able to find were made by von Groer and Kassowitz.1 They made quantitative estimation on the antitoxin content of umbilical cord blood serum in 143 new-born infants, and compared these results with like estimation made on the blood serum of the mothers. They also did intradermal toxin injections in all of these patients, and also intradermal toxin-antitoxin injections in the mothers, first making comparison between antitoxin content of sera in mothers and new-born, and second between the cutaneous reac¬ tions. Of 143 mothers, twenty-three, or 16 per cent., showed no immune bodies in the serum, while 120, or 84 per cent., showed immune bodies present. Corresponding results were found in the offspring. The intradermal tests did not give similar results; ninety-one, or 63.6 per cent., of the mothers reacted positively, while only seven, or 4.9 per cent., of the babies gave positive reactions. In view of later work we do not feel that the markedly high percentage in the mother, and the small percentage in the babies can be accepted as it is now generally believed that from 15 to 20 per cent, of adults and infants give positive intradermal reactions ; the most plausible explanation is that they were using too strong a toxin, although this leaves us at a loss to explain why so few positive reactions were obtained on the babies unless it was due to the technical difficulties of the intradermal injection in the new-born, which we shall mention later.