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For the past five years one of us (Dr. Schick) has been studying the disease that follows the administration of nirvanol (phenyl-ethylhydantoin), the drug used so widely in the treatment of chorea. The name "nirvanol sickness" was originated by von Pfaundler, who compared the disease with serum disease. There exist in both diseases a time of incubation of similar duration, a fever, rash, edema, leukopenia with relative lymphocytosis, eosinophilia, swelling of the lymph glands and other symptoms. Other similarities were pointed out by Payne and de Rudder, such as an alkalosis during the time of incubation, which changes to acidosis at the outbreak of the rash.According to the literature well developed nirvanol sickness improves the symptoms of chorea. Children show nirvanol sickness more frequently than do adults. Barbital and phenobarbital are also able to produce symptoms similar to those produced by nirvanol, although less frequently. Apparently, all of these drugs have two different effects: a pharmacologic effect, which is hypnotic, and a toxic effect, which shows in the fever and rash, as well as in other symptoms.It is impossible definitely to prove the theory that nirvanol sickness is an allergic disease. The passive transfer of allergy by the method of Prausnitz and Küstner could not be obtained. There are other dis¬

Summary The problem of the transmission of german measles to the foetus of a mother immune to the disease is discussed. The occurrence of transmission is already established (Warkany). Analogous observations in smallpox have been published. The literature of the latter is reviewed. The consequence of such transmissions in different virus diseases constitutes a warning that a pregnant mother, even if she has had german measles in childhood or is herself immune to german measles without any previous history thereof, should not take care of her children or other patients suffering from german measles. The virus may invade the circulation of the mother and reach the foetus in spite of the immunity of the mother. The difference between cellular and humoral immunity of the mother is given as explanation of the infection of the foetus. Probably only humoral immunity of the mother would prevent the infection of the foetus. Cellular immunity would protect only the mother, not always the foetus. Even rapid (accelerated) reproduction of antibodies may come too late to prevent the passage of the virus through the placenta to the foetus. Résumé Infection diaplacentaire du fætus par le virus de la rubéole malgré l'immunisation. de la mère. Observations analogues pour la variole Le problème de la transmission de la rubéole au fœtus de mères immunisées contre la maladie est discuté. La possibilité de la transmission est déjàétablie (Warkany). Des observations analogues sont publiées concernant la variole. Il est fait un eompte rendu des écrits traitant de cette dernière. La conséquence de telles transmissions dans différentes maladies à virus est un avertissement qu'une mère enceinte, même si elle a eu la rubéole dans son enfance ou si elk est immunisée contre cette maladie sans histoire antérieure de rubéole, lie devrait pas soigner ses enfants ou quelque autre malade souffrant de rubéole. Le virus peut envahir la circulation de la mère et peut atteindre le fœtus malgré 1'immunité de la mère. La différence entre 1'immunité cellulaire et humorale de la mère est donnée comme explication de la contamination du fœtus. Seule l'immunith humoralé de la mère empêche d'une manière presque totale la contamination du fetus. L'immunité cellulaire de la mère ne protégerait que cette dernière de fagon suffisante, et pas toujours le fetus. Même une production rapide des anticorps peut arriver trop tard pour empêeher le passage du virus à travers le placenta, jusqu'au fœtus. Zusammenfassung Diaplazentare Injektion des Föitus mit dem Rötelnvirus trotz der Immunitat der Mutter. Analoge Beobachtungen bei Pocken Das Problem der Übertragung von Röteln auf den Fötus bei Müttern, die gegen diese Krankheit immun sind, wird diskntiert. Die Tatsache der Übertragung ist bereits festgestellt (Warkany). Analoge Beobachtungen werden bei Pocken gemeldet. Die Literatur über diese Fälle wird besprochen. Die Folge solcher Übertragungen bei verschiedenen Viruserkrankungen ist eine Warnung für die schwangere Mutter, nicht die Pflegung ihrer Kinder oder anderer Pa...

Rowland1 defined essential xanthomatosis as "a heredofamilial, constitutional disorder of metabolism in which a deposition of fat-like mixtures, particularly cholesterol and its ester, takes place in the tissues and blood. . . . The pathologic change appears in the form of granuloma-like accumulations arising in various parts of the body."Since an accumulation of excessive amounts of cholesterol is a dominant feature of this disease, restriction of cholesterol in the diet is a rational therapeutic procedure, and it has been tried in a few instances, with considerable success. Herrmann and Nathan 2 observed definite clinical improvement in two patients after treatment with a low cholesterol diet (Pflanzenkost), the description of which was not given. In one of them the cholesterol content of the blood serum decreased from 580 to 300 mg. per hundred cubic centimeters during four months on the diet; in the other the amount of serum cholesterol remained within normal limits throughout the period of study. Ga\l=a'\l3 reported on similar treatment in a case of severe xanthomatosis, in which there were rather dramatic results. With a low cholesterol diet the amount of serum cholesterol fell from 660 to 170 mg. per hundred cubic centimeters in nineteen days. Simultaneously there was considerable clinical improve¬ ment. Schoenheimer 4 described extensive metabolic studies in a case This investigation was assisted by a grant from the Josiah Macy Jr. Foundation.