MODIFICATIONS OF WASSERMANN TEST 



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1 . Luetic extract or one of its substitutes, 



2. Active luetic serum (contains luetic "reagine" + complement). One hour in 

 incubator. 



3. Inactive hemolysin. 



4. Red blood cells. 



In view of the above-mentioned objections, especially the too frequent positive 

 results, this modification although advised by various authorities, Stern and others, 

 should not be employed. 



Not only the addition of complement, but also of immune hemolysin 

 can be discarded, because every serum normally contains hemolytic anti- 

 bodies for foreign species of blood. The contraindication for the trans- 

 fusion of foreign blood depends upon this principle. 



Accordingly, some authors advise the following schemes: 



1. Luetic extract or its substitute. 



2. Inactive luetic serum ("luesreagine" 



-f- hemolysin). 



3. Complement. One hour in incubator. 



4. Washed erythrocytes of sheep. 



1. Luetic extract or its substitute. 



2. Active luetic serum (luesreagine -h 



complement + normal hemolysin), 

 one hour in incubator. 



3. Washed erythrocytes of sheep. 



The advantage of these modifications is supposed to exist in the omission of the 

 immune hemolysin. The preparation and preservation of this ingredient is, however, 

 technically so simple that this advantage is only theoretical. Bauer believes that this 

 change is preferable to the classical method for the reason that with the latter, the vary- 

 ing amount of normal hemolysin is always added to the constant amount of immune 

 hemolysin, thereby resulting in a different quantity of the hemolysin in each test. Ex- 

 perience has, however, shown that the faint trace of normal hemoly sin ne\er influences 

 the result of the test. At times so little normal hemolysin will exist in a patient's 

 serum that it becomes necessary to add some serum of another normal patient. Such 

 manipulations lead to new difficulties so that taken all in all, this innovation offers 

 no advantages and should therefore not be accepted. 



Brieger and Renz have recently advised the substitution of potassium chlorate for 

 the immune hemolysin. 'Had this been correct the biological bases of the Wassermann 

 reaction would have been undermined. Garbat and Munk, however, have shown that 

 in this modification KC10 3 is entirely inert and that the reaction depends upon the 

 normal hemolysin in human serum against sheep's erythrocytes. 



Several workers in this field believed that it would be advantageous to 

 use a different species of blood in place of sheep's erythrocytes. 



The only suggestion which sounds theoretically correct is that of Noguchi, who 

 employs human erythrocytes and the serum of a rabbit immunized against human 

 red blood cells. In this way he attempts to exclude the heterologous normal hemol- 

 ysins, as human serum possesses no hemolysins against human blood cells. 



1. Syphilis extract or its substitute. 



2. Inactive syphilis-serum. ] 



3. Complement from hu- An active 



man being or guinea- syphilis 

 pig, one hour in incu- serum, 

 bator. 



1. Syphilis extract. 



2. Active defibrinated syphilitic blood. 



(Erythrocytes, "reagine," comple- 

 ment), one hour in incubator. 



3. Immune hemolysin of rabbit (injected 



with human blood). 



