CHAPTER LXIII 



THE COMPLEMENT FIXATION TEST FOR SYPHILIS 



RUTH GILBERT 



Division of Laboratories and Research, New York State 

 Department of Health, Albany, N.Y. 



The development of the complement fixation test for syphilis followed the funda- 

 mental work of Bordet and Gengou^ who studied fixation of complement in the pres- 

 ence of suspensions of bacteria and antiserum. They conceived the idea of adding to 

 combinations of complement, antigen, and immune serum a suspension of red blood 

 cells and the inactivated serum of an animal immunized against them so that if the 

 complement in the first combination were fixed or rendered unavailable, the red blood 

 cells would not be hemolyzed in the presence of the inactivated antiserum or ambo- 

 ceptor. This procedure demonstrated the presence of a reaction which had occurred 

 between the antigen and the serum of an animal previously inoculated or infected 

 with the micro-organism from which the antigen had been prepared. 



Wassermann and his co-workers^ thought that such a reaction might be em- 

 ployed to demonstrate the presence of antibodies in the blood of persons suffering 

 from syphilis. As the incitant of syphilis had not been cultivated, aqueous extracts 

 of the liver of a syphilitic fetus were used as antigen; guinea pig serum, as comple- 

 ment; and serum of monkeys that had developed syphilis after inoculation, as anti- 

 serum. After incubation, suspensions of the red blood cells of sheep and the inacti- 

 vated serum of rabbits that had been inoculated with sheep red blood cells were 

 added. The reagents were titrated so that suitable amounts of the various substances 

 were used and controls were made. However, these apparently did not include the 

 use of extracts made from normal tissues as antigen. 



Detre,3 working independently, tried a similar test with which he was also able to 

 demonstrate the fixation of complement in the presence of serum from syphilitic 

 patients and extracts from lesions containing Treponema pallidum. Both groups of 

 workers considered the phenomenon due to specific antigen-antibody reactions. In a 

 short time, however, it was shown by Weygandt,^ Plaut,^ and Marie and Levaditi'' 



' Bordet, J., and Gengou, O.: "Sur I'Existence de substances sensibilisatrices dans la plupart 

 des serums antimicrobiens," Ann. de VInst. Pasteur, 15, 289. 1901. 



^ Wassermann, A., Neisser, A., and Bruck, €.: "Eine serodiagnostische Reaktion bei S^-phiUs," 

 Deutsche med. Wchnschr., 32, 745. 1906. 



3 Detre, L.: "Ueber den Nachweis von spezifischen Syphilisantisubstanzen und deren Antigenen 

 bei Luetikcrn," Wien. klin. Wchnschr., 19, 619. 1906. 



-1 Weygandt, W.: "Ueber die Frage syphilitischer Antistoffe in der Zerebrospinaltliissigkeit bei 

 Tabes dorsalis," Miinchen. med. Wchnschr., 54, 1557. 1907. 



5 riaut, v.: "Serodiagnostik der Syi^hilis," Ccntralbl.f. Ncnxnh. u. Psychiat., 31, 2S9. 1908. 



'' Marie, A., and Levaditi, C: "Les 'Anlicorps syphilitiques' dans le licjuide ccphalorachidien 

 des paralyliqucs generaux et des tabctiqucs," Ann. de VInst. Piisleiir, 21, 13S. 1907. 



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