SERUM DIAGNOSIS OF GONOCOCCUS INFECTIONS IQI 



disease depends upon its specificity and the percentage of positive results. 



In epidemic meningitis, this method has been applied by 



Epidemic Bruck; while specific antibodies are undoubtedly formed, 



Meningitis, the diagnosis can more readily be made by bacteriological 



examination of the cerebro-spinal fluid. 



In tuberculosis, Koch's old and new tuberculins are used 

 Tuberculosis, as antigen. It is always best to use both of these prepara- 

 tions (0.05-0.2) as occasionally the serum will fix complement 

 with one and not with the other product. The frequency of spontaneously 

 formed antibodies in this disease is not sufficient to make this method of 

 clinical diagnostic importance. 



To Miiller and Oppenheim (1906) belongs the credit of first 



Gonococcus applying the complement fixation test to the study of the 



Infections, gonococcus infections. Meakins, Vanned, Wollstein, Teague 



and Torrey have all contributed to this subject, but 



Schwartz and McNeil's careful observations of a larger number of cases 



have proven the distinct value of this method for the clinic. 



In the preparation of the antigen, it is of paramount importance to use 

 as many different strains of the gonococcus as possible. The failure to 

 do this probably accounts for the many negative results in the early 

 period of this test. The gonococci are best grown on a salt-free veal 

 agar, neutral in reaction to phenolphthalein, for twenty-four hours; the 

 growths are washed off with distilled water and the emulsion heated in 

 the water bath for two hours at 56 C. It is centrifugalized and passed 

 through a Berkefeld filter. Salt solution is added to the antigen just 

 before it is to be used; it is then made up to 0.9 per cent, strength, by 

 adding one part of 9 per cent, saline solution to nine parts of antigen. 

 The latter can be kept indefinitely if preserved in small quantities in 

 sealed tubes, heated to 56 C. for half an hour on three successive days. 



The antigen must be titrated according to the principles outlined 

 under the Wassermann reaction. First, one-half of the maximum dose 

 of antigen which of itself does not bind complement is determined; then 

 these non-fixing quantities are titrated with a known positive human 

 serum or a highly immune rabbit serum; that dose of antigen is selected 

 which binds complement the strongest with the smallest amount of serum. 

 (Parke, Davis & Co. prepares such an antigen.) The antisheep hemolytic 

 system is used. 



Instead of using all the ingredients in one-half the quantity employed 

 in the original Wassermann technique (as below), one-tenth of the latter 

 quantity may be used. 



Concerning the clinical value of the reaction, Schwartz and McNeil 

 have thus far come to the conclusion that a positive reaction is indicative 

 of a focus of living organisms, present in the body at the time or active 



