A B S T R A C T Using a hemagglutination test which can detect antibodies to (a) native and denatured deoxyribonucleic acid (DNA) and (b) an extractable nuclear antigen (ENA), a comparative study of patterns of autoantibody formation has been done in systemic lupus erythematosus (SLE) and related rheumatic diseases. Antibody to native DNA was present in the serum in 96% of patients with active SLE and disappeared during remissions. Antibody to ENA was found in 86% of those patients with SLE nephritis who responded to treatment but in only 8% of those who did not. The highest titers of antibody to ENA were found in patients having a mixed connective tissue disease syndrome with features of SLE, scleroderma, and myositis. The latter syndrome was notable for the absence of renal disease and for a striking responsiveness to corticosteroid therapy. Hemagglutination testing of 277 sera from normal persons and patients with a wide variety of acute diseases other than SLE revealed the presence of antibody to native DNA in only 1.4% and antibody to ENA in only 0.4%.These results yield significant correlations among the pattern of autoimmune reactivity, the clinical form of the rheumatic disease, and responsiveness to treatment. They implicate the qualitative nature of the patient's immune response as a conditioning factor in the type of disease. Together with other correlations they may allow classification of rheumatic diseases into more biologically meaningful groups and lead to more selective methods of therapy.

1. No scientific basis exists for the use of the expression "a balanced diet" unless the chemical com¬ position of the component parts of the diet is known.2. In all infants and young children whose progress is not entirely satisfactory, a hemoglobin test should be made and the basal metabolism rate determined.3. In order to promote scientific pediatrics and be able to obtain satisfactory feeding results, the propor¬ tion of the mineral elements of the milk the baby is taking must be known.4. The mineral content of the milk should be improved by adding spinach concentrate, lettuce con¬ centrate or carrot top concentrate in suitable propor¬ tions to all milk, regardless of the baby's age, if the hemoglobin is below 75 per cent.5. Oysters should be investigated as a substitute for liver in conditions and diseases in which liver has been found useful.

on the infections that subsequently developed in the child. This study has been undertaken to determine whether the absence of tonsils and adenoids safeguard the child against the common infectious diseases of childhood, and if protection is not complete, to ascertain the likelihood of escape from prevalent infections as compared to the child whose tonsils and adenoids are not removed. In order to justify anv conclusion from the studv of tonsillectomized children, children

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Oregon goiter clinic we became interested in the relationship of pregnancy to goiter, because we had a group of children partly under school age and partly in the early school ages, which would not yield to treatment. In following up this group we discovered that a certain percentage of them were from goitrous mothers. Halsted, in 1896, observed that female dogs that had a large portion of the thyroid removed always had goitrous puppies. In the goiter clinic we have not studied a single goiter family, that is, a family in which all the children had goiters, without finding that the mother also had a thyroid defect. For this reason I believe that this problem should receive more consideration then it has in the past. The thyroid gland has two secretions, colloid and the active principle thyroxin. Whenever a demand comes on a thyroid for more thyroxin than it can secrete, the first reac¬ tion is an increase in colloid secretion; consequently, the ordinary goiter of pregnancy is a nontoxic colloid goiter. When the stimulation resulting in the oversecretion of colloid is not effective in causing an increased secretion of thyroxin, hyperplasia. occurs. Hyperplasia may be either of the cells lining the acini, or of the acini and in either case may result in a hyperthyroidism. Dr. Mussey spoke of the rarity of exophthalmic goiter in pregnancy. It is true that patients with exophthalmic goiter rarely become pregnant, but on the other hand, pregnant women often develop exophthalmic goiter. Pregnancy is an important etiologic factor. We are interested in the use of iodine in pregnancy. A woman must produce more thyroxin during pregnancy then at other times, and therefore needs a greater amount of iodine. While it is true that the taking of iodine will occasionally cause a nontoxic goiter to become toxic, the giving of iodine to pregnant women will insure normal thyroid glands in children, and we cannot afford to endanger hundreds of children because of an occasional mother who would be made toxic. Early in pregnancy we have edvised operation for all toxic goiter. I have never seen a death or an abortion follow the operating on a pregnant woman for goiter. Late in pregnancy I have advised the use of compound solution of iodine and the roent¬ gen ray if necessary.Dr. Carl Henry Davis, Milwaukee : I believe with Dr. Else that we can largely if not entirely prevent congenital goiter by the use of iodine during pregnancy. It is undoubtedly a mistake to let any adult patient continue to take iodine over an indefinite period unless under medical supervision. This explains why we have discontinued the use of iodine in most of these patients with delivery. This work will be continued, and I hope that these papers will stimulate a renewed interest in the subject all over the country, so that our textbooks will not continue to disregard this subject the way they have.Dr. Robert D. Mussey, Rochester, Minn. : Dr. Davis has presented an interesting and careful clinical study on the use of iodine in pregnancy. Continued investigation of ...