APPLICATION OF COMPLEMENT FIXATION 203 



Quantitative Results with the Wassermann Test. For various 

 purposes, more particularly the observation of the results of treatment, 

 it may be desirable to titrate accurately the amount of patient's serum 

 which serves as an amboceptor. This may be done by using different 

 quantities of the serum. Dilutions of the serum are made with salt 

 solution, i to 4, i to 8, i to 16, i to 32, i to 64, or are measured as 



o.i c.c., 0.05 c.c., 0.03 c.c., 0.02 c.c., o.oi c.c., etc. The tubes are treated 



w 

 in the usual fashion and the results recorded as-g-, indicating complete 



p 



fixation in dilution I to 8, -^ indicating partial fixation in dilutions of 



TT 



i to 16, indicating hemolysis or no fixation in dilutions of i to 32. 



O 



Wassermann Test on Spinal Fluid. Spinal fluids are not inac- 

 tivated and are employed in larger volumes than blood serum, up to as 

 much as i.o c.c. Hauptmann and Hossli were the first to insist upon 

 the use of large quantities of spinal fluid, and this modification changed 

 the entire conception of the frequency of positive results in the spinal 

 fluid of such diseases as paresis and tabes dorsalis. The test with spinal 

 fluid is of particular value in syphilis of the central nervous system, 

 where it is somewhat more specific than the test with blood serum. 

 The test has also been used with success with transudates and exudates 

 from the peritoneum, pleura and pericardium. Apparently of value 

 in examination of the spinal fluid is the Lange colloidal gold test, 

 described in texts of clinical pathology. 



Post-mortem Wassermann Tests. In a certain number of cases, 

 death ensues too soon after the patient comes under observation to 

 secure blood for the Wassermann test. Not infrequently the result of 

 a Wassermann test may aid the pathologist in morbid anatomical diag- 

 nosis and may furnish information of value to the clinician in the con- 

 sideration of doubtful cases. The question arises as to whether or not 

 post-mortem changes in the blood will invalidate the Wassermann test. 

 Valuable information has been collected by Graves. In a series of 

 400 cases he found that only 0.46 per cent, of sera from cadavers were 

 antilytic and only 0.58 per cent, of sera were hemolyzed, coagulated 

 or otherwise unfit for use. The post-mortem and ante-mortem results 

 were the same in 97 per cent, of sixty-eight controlled cases. " The 

 reactions conformed to the anatomic and historical evidence in 304 of 

 378 cases, or 80.4 per cent." Contradictory findings are recorded in 

 less recent literature, but we believe that valuable results may be ob- 

 tained with blood taken after death. 



COMPLEMENT FIXATION IN TUBERCULOSIS 



The advantage of a complement-fixation test in the diagnosis of 

 early pulmonary tuberculosis and in concealed or suspicious lesions is 

 obvious, Certain authors, Craig, Miller, von Wedel, report a high 

 percentage of positive reactions in tuberculous individuals, whereas 

 others, Cooper and Lange, report relatively few positive results. Petroff 

 is of the opinion that these differences may be due to lack of complete 



