334 Wassermann Reaction for Diagnosis of Syphilis 



cular stroma and saturates the fluid, transforming it from 

 the opaque pale red to a transparent Burgundy red. Some- 

 times the corpuscular stroma dissolves, sometimes it sedi- 

 ments as a colorless mass to the bottom of the tube. 



In the tubes containing the positive or syphilitic serum, and 

 in which there is complete complement fixation, the unaltered 

 corpuscles sediment to the bottom of the tube, leaving a 

 colorless fluid above. 



When the complement fixation is complete there is no so- 

 lution of the hemoglobin. Such a result has been described 

 by Citron as H \- + + . When the sedimented corpuscles lie 

 at the bottom of a slightly reddened fluid, the result is said to 

 be + + + ; when at the bottom of a distinctly red fluid, + + , 

 etc. Confusion will be avoided by making reports as positive 

 in all cases in which there is a distinct red corpuscular de- 

 posit, regardless of the state of the supernatant fluid, and 

 negative when there is no such deposit. 



When we come to inquire why the supernatant fluid should 

 be red, we reach a question that is not quickly answered. 

 In order to be in a position to explain it in certain cases we 

 introduced in our series tube 9, by which to discover whether 

 the serum under examination contains, as is sometimes the 

 case in health as well as in syphilis, rabbit corpuscle ambo- 

 ceptors. If tube 9 shows such amboceptors to be in the 

 serum, it explains the redness of the fluid bathing the cor- 

 puscles, and does not invalidate the test. If no such ambo- 

 ceptors are present and the fluid is still red, it may indicate 

 that a little of the complement remained unfixed and acted 

 upon a few of the corpuscles. 



The Validity of the Test. The Wassermann reaction is not 

 a certain test for syphilis. It is an aid in making the diag- 

 nosis, especially in cases in which there are no symptoms. 



Of thousands of bloods of normal persons examined, the 

 results are almost 100 per cent, negative. Basset-Smith has 

 had a positive reaction in a case of scarlet fever and one in a 

 case of malignant disease of the liver with jaundice ; Oppen- 

 heim, one in a case of tumor of the cerebellopontine angle; 

 Marburg, one in a similar case; Newmark reports 2 cases of 

 brain tumors with positive reactions; Cohn, a positive in a 

 patient with a cerebral tumor. These seem to form the greater 

 part of positive reactions in non-syphilitics thus far recorded. 



In active syphilis Wassermann had 90 per cent, of positive 

 reactions in 2990 cases; and most others report about the 



