1 68 METHOD OF COMPLEMENT FIXATION 



forty years after an infection, while antibodies in general persist for weeks, months 

 or at the most for several years, following an infection. Still it may be possible that 

 the syphilis "reagine" is characterized by the difficulty with which it is excreted and 

 by the tendency of the cells when once stimulated to produce antibodies to continue 

 to do so. The influence of mercury, however, demonstrates that this phenomenon is 

 closely allied to similar actions exhibited by the class of bacteria. If a patient whose 

 serum gives a positive reaction is subjected to mercurial treatment, the reaction be- 

 comes negative. The mercury has destroyed the stimulant or irritant which has led 

 the cells to the production of antibodies. If this stimulant is excluded, the "lues 

 reagine" disappears from the blood just as bacterial antibodies disappear after the 

 bacteria have been eradicated. Thus there is no basis for attributing to the luetic 

 antibodies any exceptional properties. 



The fact, that mercury leads to an alteration in the reaction, 



Citron's prompted the author to employ the Wassermann test as a 



"Biological guide to the biological mercurial treatment. The aim was not 



Mercurial only to cause a disappearance of all manifestations, but to obtain 



Treatment." a ne g a ti ve reaction. It soon appeared that a negative reaction 



once obtained did not necessarily remain so. As soon as a 



recurrence set in the reaction became positive again; in fact, the reaction 



also reappeared without a return of symptoms. In the latter case such a 



return alone was regarded as a fresh manifestation of a reactivation process 



and an indication for treatment. It became advisable, therefore, to repeat 



the test at definite intervals and depend upon the return of the reaction for 



further treatment. This basis of therapy, which at first met with marked 



opposition, has recently won many followers. 



The experiments of Boas in Copenhagen are especially instructive 

 from this point of view. 



He examined eighty-two patients with secondary syphilis before and after mercurial 

 therapy. All gave positive reactions before the treatment; after it, seventy-six gave 

 no reaction, six retained the positive reactions; one of the six did not return for observa- 

 tion. Of the remaining five, all had a return of symptoms within one month after 

 cessation of the mercury, while of the seventy-six only three returned with a recurrence. 

 Boas next made observations of sixty-five patients who were in the first three years of 

 their infection, but who gave a negative Wassermann after the treatment. In sixty- two 

 cases, a positive reaction reappeared after one to two months, eight of these having at 

 the same time a recurrence of symptoms; of the remaining fifty-four, nineteen were not 

 treated. They all showed a return of symptoms, but only one and a half months after 

 the appearance of the positive Wassermann. Thus if the scheme of the chronic inter- 

 mittent mercurial therapy of Neisser and Fournier were followed, these patients would 

 begin to get treatment one and a half months after the active lues had again started, as 

 shown by the positive Wassermann reaction. Of the remaining thirty-five cases all 

 began treatment when the Wassermann test became positive. None of these had any 

 return of symptoms during the following period of observation (three to five months). 



The experiments of Boas show distinctly the advantages of the mer- 

 curial therapy when based upon the biological reaction instead of upon the 



