COMPLEMENT FIXATION IN SYPHILIS 433 



inann. His paper is devoted to a discussion of the latter group. 

 He reports that 48 or 13 per cent of 364 consecutive cases of 

 syphilis of all types appeared to be Wassermann-fast. Of this 

 series 11 per cent were of tertiary or late syphilis, 15 per cent 

 latent, 30 per cent neurosyphilis, and 40 per cent congenital. He 

 regards it as inadvisable to consider a case Wassermann-fa.st unless 

 the complement fixation test is positive after four or more courses 

 of treatment. In his opinion, these are all cases of incompletely 

 cured syphilis. Whether such a conclusion is correct is a disputed 

 point among clinicians. 



Effect of Malarial and Diathermy Treatment. — Nicole and Fitz- 

 gerald (1931) report on a series of malarially treated cases of 

 general paralysis. Before treatment was instituted, 100 per cent 

 liad a positive spinal fluid and 89 per cent a positive blood. After 

 treatment there were 66.7 per cent whose spinal fluids and 70 per 

 cent whose blood sera showed the presence of syphilitic reagin as 

 determined by complement fixation. 



Epstein and Paul (1933) report upon a series of cases of neuro- 

 syphilis treated by means of diathermy. They state that the sero- 

 logic changes were not striking considering the group as a whole. 

 An excellent short review of the use of diathermy in the treat- 

 ment of syphilis is given by Schamberg and Butterworth (1932) 

 and O'Leary and others (1940). They report some cases showing 

 definite serological improvement, although clinical improvement 

 occurred in others without demonstrable blood changes. 



Immunity to Syphilis. — ^The subject of immunity in syphilis 

 is well reviewed by Chesney (1927), Zinsser, Enders and Fother- 

 gill (1939) and others to whom they refer. The following brief 

 summary of present concepts may be of interest to the student : 



1. Syphilis seems to be a purely human disease that may be 

 transmitted artificially to monkeys and rabbits. Zinsser (1939) 

 says that the reported transmission of syphilis to the Ihuna is 

 not borne out by subsequent investigation. 



2. There is no evidence of natural, individual or racial im- 

 munit^^ 



3. In acquired syphilis, reinfection is possible during the in- 

 cubation period and most of the primary stage of the disease. 

 A refractory stage develops which, all agree, persists during the 

 secondary stage and in many cases much longer. 



