COMPLEMENT FIXATION IN SYPHILIS 437 



Kduni is tlie cause of syphilis, it oeciu-red to Wasserinann that 

 this disease might be diagnosed by bacterial complement fixation. 

 He and his colleagues prepared an antigen by extracting a syph- 

 ilitic fetal liver, rich in spirochetes, with saline. They did this 

 five years before Noguchi taught the scientific world how to cul- 

 tivate Treponema pallidum. They found that the saline extract 

 possessed some antigenic property as measured by complement 

 fixation. In their opinion this complement-fixing property de- 

 pended upon the spirochetes present. Within the next year, Marie 

 and Levaditi (1907) and also Landsteiner, Miiller and Potzl (1907) 

 showed that spirochetes are not the antigenic factors in the Was- 

 sermann antigen but that alcohol-soluble lipoids from normal heart 

 muscle and other tissues are the substances that adsorb syphilitic 

 reagin and thus bind complement. 



6. Six stages in the development of our present serological 

 metliods used in the diagnosis of syphilis are next discussed. These 

 include the original Wassermann technique and concepts; the 

 discovery of lipoid antigens ; the discovery that cholesterol increases 

 the sensitivity of lipoid antigens ; the modification of Neymann and 

 Gager ; the modifications of Kolmer and the present stage in whicli 

 a general standardization of the Wassermann based upon extensive 

 experimental, clinical and statistical studies is nearly completed. 

 The flocculation test is becoming an accepted adjunct to the Was- 

 sermann test. 



7. The various experimental studies of Kolmer and his col- 

 leagues are summarized and discussed. Likewise the recommen- 

 dations of the Committee on Adherence to Conventional Technique 

 in the Performance of Reliable Serologic Tests for Syphilis. 

 Kilduffe's ten basic principles governing the serological diagnosis 

 of syphilis are also presented. 



8. The student is made acquainted with the importance of um- 

 bilical cord Wassermanns and of the meaning of the terms "Was- 

 sermann-f ast " and ''provocative Wassermann." The effect of 

 diathermy and malarial treatment on the blood Wassermann is 

 also mentioned. 



9. Reference is made to Chesney's (1927) excellent monograph 

 on Immunity in Syphilis and to a recent paper on reinfection 

 in syphilis. Chesney seems to approve of Neisser's views that 

 "anergy" and "allergy" are important factors in the body's 



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