The idea that some form of sensitization might be associated with the development of blackwater fever has been previously suggested by Foy, Altmann, Barnes and Kondi (1), and Fernán-Núñez (2). The idea expressed in this preliminary note was developed from the studies of these workers and those of Whitmore (3, 4).
In 1940, Landsteiner and Wiener (5) described the existence of a new factor in human bloods (the so-called “Rh Factor”). In 1941, Burnham (6), and Levine, Katzin and Burnham (7) associated the Rh factor with erythroblastosis fetalis.
With these basic observations as a nucleus, let us now consider the theoretical possibilities of the Rh factor, or an Rh-like substance, in the causation of blackwater fever.
Following the demonstration of the Rh factor in the blood, Landsteiner and Wiener (8) showed that the factor (agglutinogen) was inherited as a simple Mendelian dominant. Later, Levine, Vogel, Katzin and Burnham (9) demonstrated the isoimmunization pathogenesis of erythroblastosis fetalis.