Numerous investigators (I to I I) have noted that when pneumococci are grown in immune serum the organisms exhibit unusual characterisC~ics, Certain observers have also shown that the sera of animals immunized to pneumococci are able to cause agglutination of these organisms when the ordinary agglutination technique is employed.In 19oo Besan~on and Griffon (12) noted the presence of agglutinins in the blood of patients ill of and convalescent from lobar pneumonia. They found that often the homologous strain (,the strain derived from the patient) was agglutinated when a heterologous strain was not. This fact suggested that the various strains of pneumococci might possess biological differences which could not be detected by ordinary cultural methods. Eyre and Washbourn (I3) and Garg~.no and Fattori (14) also noted such differences, bu~ Neufeld and H~indel (I5) were the first to study thoroughly immunological variations in pneumococci. They worked, however, with relatively few strains of pneumococci. Dochez (i6) and Dochez and Gillespie (I7), working with a large number of strains of pneumococci, isolated from patients suffering from lobar pneumonia, were able to differentiate pneu,mococci into four groups on the basis of cultural and immunological reactions. The three main groups were distinguishable by agglutination and animal protection experiments with a fourth group which includes all strains of pneumococci which cannot be otherwise classified.More recently Lister (I8) in South Africa, approaching the problem from another standpoint, has differentiated into four groups eighteen of twenty strains of pneumococci isolated by puncture of the lungs of patients having lobar pneumonia. This he was able to do by cross agglutination tests with cultures of these strains of pneumococci and the sera derived from these patients at about the time of crisis. Two strains he found to be non-agglutinable.The present study has been carried out with the purpose of determining the time of appearance and disappearance of agglutinins in the blood of patients suffering from pneumonia, and of learning more concerning the specific character of these agglutinins, especially their specific relation to the various groups of pneumococci.
Previous work has shown that the occurrence of a specific precipitin reaction between a serum of one animal species and its antiserum may result in a very definite action on normal or immune antibodies comained in the first (precipitinogenic) serum.Such studies were inspired by the work of Camus and Gley (i), Kossel (2), and Bordet (3), who had shown that antihemolysins were formed by immunization against a hemolytic serum, and were designed to determine whether similar antibodies could be produced to antitoxins, agglutinir~s, precipitins, and the like.Kraus and Eisenberg (4) succeeded in producing an antilactoserum, the action of which was apparently due to the carrying down of the precipitin of the lactoserum with its precipitinogen which had been allowed to interact with the antilactoserum. In other words, the serum of a rabbit immunized against milk when precipitated by the serum of a goat immunized against rabbit serum removes the precipitin for milk from the lactoserum. The first combination was for some reason not effective when a dog-antirabbit serum was employed. These same authors failed, however, to demonstrate fixation of tetanus antitoxin or of typhoid agglutinin in horse serum after precipitating the horse serum by means of rabbit-antihorse serum. Their failure to remove the antitoxin was, however, due to the excess of precipitinogen (horse antitoxin.) employed, an inhibiting factor to precipitate formation that was then unknown. This difficulty was overcome by Dehne and Hamburger (5), who found that diluted (1:5oo) horse antitoxin was entirely removed from the supernatant fluid on producing a precipitate with rabbit-antihorse serum. These experiments were fully corroborated by Krans and Pribram (6), Hamburger (7), and yon Eisler and Tsuru (8), and analogous facts were produced in respect to the fixation of diphtheria antitoxin in horse serum by Weill-Hall6 and Lemaire (9) and by Atkinson and Banzhaf (IO). Experiments which indicate that a similar removal of antitoxin takes place in the body of immunized animals were performed with diphtheria antitoxin by Sacharoff (II) and with tetanus antitoxin iby Dehne and Hamburger (5).Some difference of opinion exists as to the carrying down of agglutinins with a precipitinogen when antiserum is added, the results obtained doubtless depending on technical differences. Thus, Kraus and Eisenberg (4) at first failed to remove immune agglutinins, but later Krans and Pribram (6) succeeded. Von Eisler and Tsuru (8) and Landsteiner and Pra~ek (12) brought down normal *
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