MUCH AND HOLZMANN " PSYCHO-REACTION 99 



Calmette notes in the blood of tuberculous patients more than the nor- 

 Cobra loxm , ri ... . . . . . . . 



. . . mal amount of lecithin; for that reason their serum can be used in very 



small doses to activate the cobra hemolysin. By this means he attains 



, . a diagnostic reaction for tuberculosis. On examination of the blood of 

 luberculosis. . , . ,. . , . . . 



177 tubercular individuals he has found: 



78 per cent, of positive reactions in the first stage of tuberculosis. 



57 per cent, of positive reactions in the second stage of tuberculosis. 



70 per cent, of positive reactions in the third stage of tuberculosis. 

 Szaboky has confirmed these findings, but not enough control examinations of normal 

 individuals or of other infections had been made to firmly establish the diagnostic 

 value of the test. 



At the instigation of the author, Alessandrini repeated the work of 

 Calmette but came to different conclusions. The reaction was not 

 found specific for tuberculosis; it was given by various other diseases. 

 Furthermore Alessandrini could not confirm the hypothesis that hemolysis 

 was dependent upon the lecithin or lipoid content of the serum. By 

 simple mixture of cobra poison and horse's erythrocytes, he found that 

 the resistance of the cells toward any traumatism becomes greatly 

 diminished so that hemolysis can be attained even by hypotonic salt 

 solutions in concentrations which under normal circumstances are entirely 

 ineffective for horse's red cells. 



The hemolysis of snake poison can be overcome or interfered with by the 

 addition of large amounts of normal serum, cholesterin, and small amounts 

 of snake poison serum. 



Much and Holzmann have recently described the so-called "Psycho- 



The Psycho- reaction" which can be explained thus Normal serum, when added to 



reaction, a mixture of cobra extract and human red blood-cells will not interfere 



with consequent hemolysis. If, however, the serum is obtained from 

 patients suffering from depressive mania, circular insanity or dementia praecox, and 

 added to the cobra extract and human red blood-corpuscles, the expected hemolysis 

 does not take place. One would naturally suppose that this fact would be employed 

 for clinical diagnosis, but unfortunately it has been generally proven by most authori- 

 ties that it is altogether impossible to do so for the simple reason that it is not abso- 

 lutely specific. Bauer has found the same reaction with navel blood. It is probable 

 that the interference with hemolysis is brought about by an increase in the cholesterin 

 of the serum a greater possibility in diseases of the central nervous system than 

 in any physiological or other pathological condition. 



Cobra In immunizing laboratory animals one cannot start with 

 Immunity, inoculations of the unaltered snake poison. 



Phisalix and Bertrand begin with subcutaneous injections of a toxin heated to 

 75 C. and after two days use one-half of the minimal lethal dose of the unaltered 

 toxin. 



Calmette weakens the cobra poison by the addition of an equal amount of r per 

 cent, gold chlorid, and after four such injections with increasing amounts at each time, 

 the pure toxin in very small doses is employed. 



