In five out of eight patients with thrombocytopenic purpura, the onset or reactivation of the disease followed a long period of psychic stress. This in several cases involved loss or threatened loss of the mother or of a substitute for the mother. In some cases of thrombocytopenic purpura, sudden increased bleeding in the active stage of the disease, or spontaneous bruising in the quiescent phase, occurred after an upsetting experience.

Two cases of familial spherocytosis were studied. In one case a crisis and in the other an episode of sharply increased hemolysis occurred after upsetting experiences. In some cases of sickle-cell anemia crises occurred after emotional upsets.

Several mechanisms that could account for some of these observations are discussed.