WASSERMANN-BRUCK'S MODIFICATION. 



161 



The spinal fluid contains meningococcus antigen thus proving that the patient is 

 suffering from epidemic cerebrospinal meningitis. Neither the double amount of serum, 

 a double amount of antigen, a mixture of normal spinal fluid with specific serum, nor 

 normal serum with the specific spinal fluid binds complement. Only a mixture of meningo- 

 coccus extract and specific serum gives complement fixation. 



The results gotten by complement fixation greatly depend upon the 

 quantitative relationship of the various ingredients. The affinity toward 

 the complement existing between the antigen and amboceptor on the one 

 hand, is balanced by that between the hemolysin -h blood on the other. 

 By modifying their quantitative proportions different results maybe obtained. 

 If for example the strength of the hemolysin is excessively increased, it is 

 possible that the previously bound complement is again detached and hemo- 

 lysis ensues. Originally the results were read after the mixtures had 

 remained two hours in the incubator and twenty-four hours in the ice-box. 

 At the present, most authorities agree to read the results at a time when the 

 control tubes are ready; that is when the complement is bound or hemolysis 

 has been completed in those tubes in which these respective phenomena 

 should occur. 



Wassermann's modification of the Bordet-Gengou method was first 

 practically employed for the titration of the therapeutic meningococcus 

 serum. One cannot, however, correctly judge the prophylactic or curative 

 value of a serum by its antibody content as they do not run hand in hand 

 [R. Kraus, Garbat, Citron.] The complement fixation method was also 

 applied by Bruck for the diagnosis of epidemic meningitis; by Miiller and 

 Oppenheim for the diagnosis of general gonococcus infections (gonorrheal 

 arthritis, iridocyclitis, etc.) and by Hirschfeld, Leuchs and Schone and others, 

 in typhoid all with favorable results. 



