summ,ARY Fifteen patients with ulcerative colitis and 11 patients with ulcerative proctitis have been observed and studied for periods ranging from one to 15 years. It is suggested that the clinical course of the two disorders is quite distinct. Further, while the serum immunoglobulins were within normal limits in ulcerative proctitis, significant increases in the serum 012-, P-, and y-globulins and in the IgA and IgG concentrations were found in ulcerative colitis.Despite total colectomy for ulcerative colitis, the serum IgG and IgA concentration remained high and even after subsequent rectal resection the relative IgA concentration continued to increase. The significance of these findings is discussed.Bloody diarrhoea without systemic disturbance and with mucosal changes confined to the rectum may not progress to frank ulcerative colitis. Haemorrhagic or ulcerative proctitis can, we believe, be differentiated from ulcerative colitis, even in its milder forms, on clinical and serological grounds. Autoimmune factors may be involved in the aetiology of ulcerative colitis but the results from tests in vitro for serum antibodies against alimentary antigens have been inconclusive (Polcak