1 Department of Pediatrics University of Washington School of Medicine Seattle, Washington 98105
Almost 20 years ago in this journal, Bruton1 described a young boy afflicted with recurrent severe infections, who lacked gamma globulin. His description identified a new disease and heralded a new era in immunobiology. "Agammaglobulinemia," the term he coined, described a condition of immunodeficiency in a manner analogous to the use of the term "anemia" in the description of abnormalities in erythrocytes. The delineation and treatment of immunologic defects require a conceptual framework for the understanding of immune responses in man, just as the specific diagnosis and therapy of anemia require knowledge of iron metabolism, hemoglobin synthesis, and erythrocyte production.