ANTE-NATAL HYGIENE : DISCUSSION 395 



time past he had tested a good many really marasmic 

 infants infants who failed to respond to the ordinary 

 methods of feeding and general infant care; the kind of 

 infant who remained stationary, in spite of the absence of 

 any vomiting or diarrhoea, or any other sign that was 

 obviously the cause of its wasting; the infant who refused 

 to get on and yet showed no signs of syphilis. He had had 

 them tested fairly largely with this blood test, and he had 

 found that they gave invariably negative results. Every 

 now and again there cropped up a case amongst these 

 infants which showed some definite syphilitic sign and the 

 blood of these children went up to the University just the 

 same as did the blood of the children he had been testing 

 for wasting only, and it was a most striking fact that time 

 after time " negative reaction " was the reply. He thought 

 that the reason why Professor Mott saw so many cases was 

 because he had exceptional opportunities of seeing the par- 

 ticular class of cases in the asylums and other institutions; 

 but he thought that as a rule amongst the ordinary wasting 

 infants syphilis was not so frequent as was supposed. 



Dr. RUGH (Philadelphia Paediatric Society) said he would 

 like to ask if it was Dr. Mott's experience that the Wasser- 

 mann test was more accurate in childhood than it was in 

 adults. In Philadelphia the question was often raised, and 

 to a certain extent discredit was thrown upon the Wasser- 

 mann test for syphilis, because it had been generally recog- 

 nized that the result of the test depended so very much upon 

 the laboratory worker who was making it. He did not 

 know. He did not know from his own experience or from 

 the laboratory whether the test was more accurate in the 

 infantile cases of congenital syphilis than in adult cases. 

 He knew of one case of a youth where there was a suspicion 

 of syphilis, and the Wassermann test was tried by four or 

 five different laboratory workers, and a negative report 

 made in each instance. A short time afterwards the patient 

 died, and a post-mortem was made, and the live Spirochceta 

 pallida was found in the spinal cord. 



Dr. ERIC PRITCHARD (London) said that in reference to 

 the application of the Wassermann test he would like tc ask 

 the author whether he could make any suggestion for carry- 

 ing out the test with greater facility in infants. He had 

 sent up a large number of infants for this test, and quite 

 30 per cent, were returned by the pathologist without the 

 test having been performed because sufficient blood could 

 not be obtained to perform the test with accuracy. In 

 those cases they sometimes had the Wassermann test per- 

 formed on the mother and sometimes on the father, but 



