COMPLEMENT FIXATION IN SYPHILIS 423 



five serological findings as compared Avitli 45.8 per cent of the 

 treated cases. The Kolmer complement fixation test was positive 

 in 32.6 per cent of the untreated and 34.0 per cent of the trealed 

 cases, while the Kahn precipitation test was positive in 41.3 per 

 cent of the former and 49.8 per cent of the latter. 



In a series of 889 treated cases of syphilis in which the stage 

 of tlie disease is not mentioned, Heathman and Iliggenbotham 

 (1932) found the Kolmer- Wasscrmann complement fixation test 

 positive in 63.1 per cent, the Kahn in 66.7 per cent and the Kline 

 in 73.8 per cent. In 150 untreated cases of syphilis, the Kolmer- 

 Wassermann test was positive in 88.6 per cent, the Kahn and Kline 

 flocculation tests in 90.6 and 92.0 per cent, respectively. 



Tabes, Paresis, and Cerebrospinal Lues Late Manifestations 

 OF Tertiary Stage of Syphilis.— Other late tertiary manifesta- 

 tions of syphilis, considered by some as symptomatic of a qua- 

 ternary stage or parasyphilis, are due to involvement of the central 

 nervous system. These are represented by tabes dorsalis, paresis 

 and cerebrospinal lues. It is generally agreed that spinal fluid 

 examinations are of paramount importance in obtaining laboratory 

 evidence of syphilis of the nervous system. Blood tests may be 

 negative, Avhile spinal fluid examinations may give definite labora- 

 tory evidence of syphilis. Nonne, according to Levinson (1919), 

 reported both blood and spinal fluid Wassermann tests positive 

 in 100 per cent of his cases of general paresis. In tabes Avithout 

 paresis, the blood was positive in 60 to 70 per cent, in cerebrospinal 

 lues it was positive in 80 to 90 per cent, while the spinal fluid was 

 positive in 100 per cent of both in the series he reported. His data 

 were obtained before Kolmer introduced his modification of the 

 Wassermann test or Kahn and Kline had perfected their modifica- 

 tions of earlier flocculation tests. 



The series of events leading up to the introduction of the com- 

 plement fixation technique as an aid in the diagnosis of syphilis 

 form an interesting chapter in the history of diagnostic serology. 



Wassermann and Bruck Modification of the Bordet-Gengou 

 Technique for Bacterial Complement Fixation. — In 1905 Wasser- 

 mann and Bruck were interested in finding some method of 

 standardizing meningococcus immune serum and finally reported 

 that a modification of the Bordet-Gengou complement fixation 

 technique gave satisfactory results. The modified procedure which 



