SIGNIFICANCE OF ALLERGY 553 



is unstable, ])re('ipital)l(' with small volumes of aleohol, and Apitz 

 says it is not the same substance as the type-specific carbohydrates, 



Stolyhwo (1936) reports that the active Shwartzman substance 

 is concentrated in the urine of typhoid patients. He thinks the 

 active substances may be responsible for severe intoxications in 

 typhoid fever. 



Frei Test in Lymphogranuloma Inguinale. — DeWolf and Van 

 Cleve (1932) give an excellent discussion of lymphogranuloma 

 inguinale and of the intradermal test suggested by Frei (1925) 

 for its diagnosis. It seems to be established that the disease is 

 venereal and caused by a filtrable organism which according to 

 Tamura (1934, 1935) can be cultivated in vitro. According to 

 DeWolf the antigen for the original Frei test is prepared by 

 making a one to ten dilution of pus obtained from a suppurating 

 gland. Physiological saline is used as a diluent. The prepara- 

 tion is then heated at 60° C. for two hours on one day and one 

 hour on the next day. It is then cultured for sterility, and if no 

 bacterial growth is obtained, the material thus prepared is used 

 as an antigen in 0.1 c.c. amounts for intradermal injection into 

 patients suspected of having the disease. 



DeWolf and Van Cleve state that cutaneous allergy develops 

 quite early in the disease and persists for a long period after 

 recovery. A positive skin reaction develops at the site of the 

 intradermal injection within twenty-four hours and persists for 

 several days. The reaction appears as an inflammatory papule 

 and resembles a positive tuberculin reaction. The authors regard 

 it as of great diagnostic value. 



Tamura (1934, 1935) reports the successful cultivation of the 

 virus in a medium consisting of filtered Tyrode's solution and bits 

 of sterile rabbit or guinea pig tissue as suggested by Maitland, 

 Laing and Lythe (1932) in their cultivation of vaccinia virus. 

 Tamura reports that in cultures of the virus in this medium the 

 supernatant fluid becomes cloudy and that it can be heated and 

 used as an antigen in the Frei test and also in immunization ex- 

 periments. 



Connor, Levin and Ecker (1937) report that the Frei test is 

 specific for lymphogranuloma inguinale and that a positive test 

 has been obtained as long as 39 years after the infection. 



