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Definite associations were demonstrated between OS-activity, birth weight, and signs of immaturity. These associations were tested by 3 different methods (Pattle method, investigation of an extract in the Wilhelmy balance, P/V diagram) and simultaneous histological examination in 44 babies (premature, immature, stillborn and those dying from hyaline membrane disease). The pathogenetic picture of the development of the idiopathic respiratory distress syndrome is summarized in a scheme. Comments are made on the methods of measurement for ascertaining the conditions of surface tension, and the pertinent literature is discussed.