340 IMMUNOLOGICAL METHODS OF DIAGNOSIS 



syphilis, in one of hereditary syphilis, and in two cases of secondary 

 syphilis, all being under mercurial treatment. 



"If no change occurs after four or five days the reaction should 

 accordingly not be termed negative and Noguchi advises that the 

 observation of the patient be continued for at least three or four 

 weeks. 



"Neither in syphilitics nor in parasyphilitics did a marked con- 

 stitutional effect follow the intradermic inoculation of the luetin. 

 In most positive cases a slight rise in temperature took place, lasting 

 for one day. In three tertiary cases and in one hereditary case, 

 however, general malaise, loss of appetite, and diarrhea w r ere noted." 



Results. As regards the specificity and the value of the Noguchi 

 reaction from a diagnostic stand-point there can be but little doubt, 

 and it seems from the data which are thus far available that it is 

 especially serviceable in the late stages of the disease, and in the 

 recognition of congenital cases. 



Noguchi expresses the belief that the allergic condition of the 

 skin persists as long as the infecting agent still survives somewhere 

 in the body, and that its disappearance, cceteris paribus, implies the 

 cure of the patient. It is to be noted, however, that cases occur in 

 which the disease persists in spite of treatment and in spite of the 

 absence of the luetin reaction. 



Kammerer, who has repeated Noguchi's work, sums up his experi- 

 ences as follows: 



The intracutaneous reaction is devoid of danger and entails no 

 special discomfort for the patient. Aside from one uncertain case 

 it was specific for syphilis. A differentiation between the specific 

 and non-specific traumatic reactions is possible in most though 

 not in all cases. In cases of marked reaction the control site also 

 often responds to the point of vesicle or even pustule formation. 

 Of the cases examined which were known to be syphilitic more than 

 half did not give the reaction, the highest percentage of positive 

 findings occurring in late cases. In view of the occurrence of retarded 

 reactions the patients should be observed for two weeks. 



My own observations have been rather scanty. In the beginning, 

 when 0.5 per cent, carbolic was used as a preservative, it was diffi- 

 cult to guard the preparation against contamination. With the use 

 of the cresol the danger from this source is certainly less, but I must 

 confess that a couple of very severe local reactions (very curiously) 



