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Interest in the humoral immune properties of the blood of patients with pneumococcus lobar pneumonia has centered principally on the possible relationship of acquired anti-pneumococcal activity of the serum to recovery from the disease. While much information has been collected on the subject by numerous workers, the nature of this relationship still remains problematical. Actually little has been added except corroboration to the results of Dochez's original investigation (1912) (1) in which he found that at about the time of crisis the blood serum of most patients recovering from pneumonia, in contrast to fatal cases, acquired the ability to protect mice against infection with highly virulent pneumococci. However, this immune property was not detected in every case and its appearance did not always coincide with the time of recovery. More recent studies have shown that the appearance of acquired antipneumococcal activity in the serum marks the termination of bacteremia I but whether this manifestation of the body's reaction is of primary or secondary significance in the mechanism of recovery, the present methods of investigation have failed to reveal. A somewhat different conception of the problem was offered us by finding that the blood serum of normal human beings, as a group, possesses well marked pneumococcidal-promoting properties as shown by the in-vitro action of human serum-leukocyte mixtures (2).2 The observation further that the serum of certain individuals lacked this property for one or more of the types of pneumococcus, while exhibiting it for the other types, suggested that there might be a relationship between the presence or absence of natural antipneumococcal humoral immunity and the inception of lobar pneumonia. A study of the serum activity of pneumonia patients, very early in the course of the disease, not only failed to disclose any such re-

THE RELATION OF CIRCULATING ANTIPNEUMOCOCCAL IMMUNE SUBSTANCES TO THE COURSE OF LOBAR PNEUMONIA II. ACQUIRED IMMUNE SUBSTANCES