WASSERMANN REACTION. 151 



nor a pure lipoid substance. The author has expressed the hypothesis to the effect that 

 the antibody producing antigen is a toxolipoid. This explains the fact why pure lipoids 

 can stimulate no antibodies, but can at the same time react with luetic antibodies in 

 vitro. 



The accompanying diagram (Fig. 17) explains this hypothesis. In 

 order to answer the objections raised against this theory, the author has 

 proposed the indifferent term of "Lues- 



reagine" for the luetic antibodies as long f V7 Syphilis virus 



as their biological structure is unknown. Lues-Antigen j vW 



Independent of the question of U/ Lipoid aecithinj 



"biological specificity," the Wassermann 



reaction must also be considered in the 



Amboceptor 



light of a " clinical specificity." From 



Lipoidophile group 



Complementophile 

 group 



this standpoint it fulfills its demands. 

 With only few exceptions, it can be con- 

 sidered absolutely specific for lues. / \ Complement 



The well established exceptions are, fram- 

 bcesis, trypanosomiasis, leprosy, malaria, scarlet, p IG I ^ > 



febris recurrens. The reactions obtained here 



are similar, but not the same as those obtained in syphilis. In leprosy the point of 

 difference is seen in that the reaction can also be performed with tuberculin as antigen; 

 in scarlet the reaction appears only in a small percentage of cases and not with all luetic 

 extracts. Furthermore, it disappears at the latest three months after the infection, usually 

 much sooner. As for trypanosomiasis and malaria convincing data are still too few. 



These diseases excluded, a positive Wassermann reaction can be taken 

 as certain proof for the existence of lues. Whether such a test is indicative 

 of a by-gone infection or whether it means that an active process is still 

 going on at the time of its obtention has been for a long time a subject of 

 discussion. The author is of the firm opinion that the demonstration of the 

 "lues reagine" means active Iws. The reasons for this belief are as follows: 



1. The almost constant presence of the reaction in all cases of manifest 

 lues excepting primary lesions. During this stage it is entirely absent or 

 only partly detected. It appears, however, later on. 



2. The practically assured existence of the reaction with a recurrence of 

 symptoms even if before that the reaction was negative. 



3. The possibility of influencing a positive reaction so that it becomes 

 negative, by the use of mercury. The latter holds true also for those cases 

 which show no symptoms and are therefore incorrectly designated as latent 

 syphilis. It has been proven that such are in reality by no means latent, 

 but have an active process at some point escaping detection, as the aorta. 

 Only cases of a nature which have no symptoms and a negative reaction 

 should be considered as latent syphilis, those however with no symptoms, 

 but a positive reaction as belonging to the class of active lues. 



4. The evidence that apparently healthy individuals, but with a positive 



