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1. A study has been made of the relationship between the concentration of internal calcium and the permeability of human red cell membranes to sodium and potassium.

2. Fresh red cells contain very little calcium, but after being depleted of ATP by ageing they took up calcium from Ringer solution. The entry was unaffected by external sodium and potassium but was markedly pH dependent. When supplied with energy, calcium-loaded cells actively extruded calcium by a saturable process which was also unaffected by the distribution of sodium and potassium across the membranes. The activity of the calcium pump was sufficient to maintain the low internal concentration found under physiological conditions.

3. Raising internal calcium in metabolically poor cells caused a loss of cell potassium which was greater than the concomitant sodium gain. These changes were reversed when ATP was supplied. External calcium had no effect. The increase in permeability to sodium and potassium was enhanced by the simultaneous addition of fluoride, and, even more so, of iodoacetate. These inhibitors had no effect on membrane permeability unless calcium was also present. Inosine potentiated the action of fluoride and iodoacetate in causing potassium loss, by allowing more calcium to enter the cells.

4. The results suggest that the permeability of human red cell membranes to sodium and potassium is regulated by internal calcium, which in turn is controlled by a calcium pump that utilizes ATP.