A proven case of paroxysmal nocturnal hemoglobinuria is reported in which the patient was treated with ACTH on three occasions. Following an initial failure, the second course of ACTH resulted in a dramatic deceleration of hemolysis which, however, lasted only a short time after the cessation of treatment. A third attempt was again of no avail in relieving the condition. Treatment with dicumarol coincided with a remission of the hemolysis which has lasted, so far, for five weeks.

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