428 IMMUNOLOGY 



of the plain alcoholic extract of beef heart, thus insuring a certain 

 uniformity in lipoid content of the three antigens. 



Fifth Stage: Standardization of Wassermann Reaction by 

 KoLMER. — The fifth stage began with the extensive investigations 

 of every aspect of the complement fixation test for syphilis by 

 Kolmer and his colleagues in 1919 and ended with his recommen- 

 dations for a standard qualitative and quantitative Wassermann 

 technique in 1922 and 1925. These are generally spoken of as the 

 Kolmer or Kolmer- Wassermann qualitative or quantitative com- 

 plement fixation reactions in syphilis. 



A sixth stage exists at the present time and is one of revalua- 

 tion, reconciliation, reinvestigation, and coordination. The com- 

 plement fixation test for syphilis is assuming greater value in all 

 laboratories where an unmodified Kolmer technique is employed. 

 Clinical pathologists who have either published or adopted various 

 modifications of the Wassermann technique have been slow to aban- 

 don these methods and adopt Kolmer 's recommendations in their 

 entirety, but a perusal of the literature seems to indicate that there 

 is a slow but definite trend in that direction. The American 

 Public Health Association is actively interested in the standard- 

 ization of the Wassermann reaction as evidenced by the fact that it 

 has a committee of which Ruth Gilbert is chairman, working to- 

 ward this end. 



An extensive literature that has been augmented recently shows 

 rencAved interest in the physicochemical aspects of complement 

 fixation and may lead to further improvement in technique. There 

 is also a growing conviction among serologists that a flocculation 

 test such as the Kahn or Kline should be done simultaneously with 

 the Kolmer complement fixation test on each serum. 



In order that the student may appreciate the value of the ex- 

 tensive investigations of the Wassermann reaction carried out by 

 Kolmer, a list of his publications leading to the first Kolmer com- 

 plement fixation test is included in references at the end of the 

 chapter. 



Kolmer Test. — In the preceding chapter (XXII) the technique 

 is given for Kolmer 's bacterial complement fixation test. Except 

 for the differences in antigens the technique for the Kolmer 

 modification of tlie Wassermann used in the diagnosis of syphilis 

 is the same. It is described in detail in United States Public 



