330 Wassermann Reaction for Diagnosis of Syphilis 



TABLE II. Series with the Syphilitic Serum. 

 Tubes. 



1. i unit of + i unit of +- antigen o.oi '2 jjjj = Complete 

 complement syphilitic serum ^ hemolysis. 



2. i unit of + i unit of + antigen 0.03 g^ G~ = Complete 

 complement syphilitic serum -o|^^ hemolysis. 



3. i unit of + i unit of + antigen 0.05 g% >- ^'5 Sugges- 

 complement syphilitic serum sSftSj tion of 



** <u g S hemolysis. 



4. i unit of + i unit of + antigen 0.07 .S^-2 = Slight 

 complement syphilitic serum ^ M * hemolysis. 



6. i unit of + i unit of + antigen 0.08 | g"3 | = Partial 

 complement syphilitic serum "o^^^ hemolysis. 



6. i unit of + i unit of + antigen 0.09 H'^'S g a = No 

 complement syphilitic serum ^- ^ H a hemolysis. 



7. i unit of + i unit of + antigen o.i .*^| S'g = No 

 complement syphilitic serum 2 <g H^ hemolysis. 



8. i unit of + i unit of + antigen 0.12 ^Irf gt> := ^No 

 complement syphilitic serum J> g . hemolysis. 



9. i unit of + i unit of + antigen 0.15 g 8 g = No 

 complement syphilitic serum Jt g-" 5 "! hemolysis. 



10. i unit of + i unit of + antigen 0.18 b^-Siy = No 



complement syphilitic serum ST13'I j| hemolysis. 



From this we find that the unit of antigen is 0.09 c.c. 

 The largest quantity of the antigen that can be added 

 without preventing hemolysis when the normal serum is 

 used is probably 0.18 c.c. At the same time 0.09 c.c. is 

 the smallest quantity that can be added, when the syph- 

 ilitic serum is used, to prevent it. In this case the dose 

 exactly fulfils Kaplan's requirement that " The unit dose of 

 antigen must completely inhibit hemolysis ... of a known 

 luetic serum, provided double the dose does not interfere 

 with the complete hemolysis of cells using a known normal 

 serum and complement." 



We have now accomplished the titration of all five of the 

 factors involved in making the Wassermann reaction, but 

 we have done more, we have really done the test, and have 

 seen positive and negative results, for in titrating the anti- 

 gen we have developed the reaction by which we can confirm 

 the diagnosis of syphilis in the case from whom the syphilitic 

 serum was obtained, and have failed to develop it with the 

 known normal serum. 



However, in order that those who perform the test may be 

 able to escape the numerous errors into which one may fall, 

 it will be necessary to point out the controls by which they 

 can be escaped. 



A Wassermann reaction at the present time comprises not 

 only the test of the patient's serum, but simultaneously in- 

 cludes a long series of other tests by which the validity of 



