33 6 Wassermann Reaction for Diagnosis of Syphilis 



Noguchi also varies the technic in such a manner that very 

 small quantities of the various reagents are employed a 

 necessity that arises from the relatively small quantity of the 

 patient's blood obtainable according to the method he em- 

 ploys. The reagents employed are as follows: 



(1) The Serum to be Tested. To obtain this, Noguchi binds 

 the finger of the patient with a rubber band, makes a good- 

 sized puncture near the root of the nail with a Hagedorn 

 needle, and collects about 2 c.c. of the blood in a Wright tube 

 (see directions for making the opsonic index). The blood 

 soon coagulates in the tube, which is then scratched with 

 a diamond or file, broken, and the serum removed with a 

 capillary pipet. The serum may or may not be inactivated 

 by heat, according to the option of the experimenter. The 

 dose of the unheated serum is i drop; of the inactivated 

 serum, 4 drops. The same doses of the normal and syphilitic 

 control serums are used. 



(2) The Complement. This consists of fresh guinea-pig 

 serum. Of it he makes a 40 per cent, dilution in physiologic 

 salt solution by adding one part of the serum to i^ parts of 

 the salt solution; o.i c.c. is the unit. Two units constitute 

 the " dose." 



(3) The Antigen. The antigen is made, according to the 

 directions given in the description of the Wassermann 

 test, out of normal guinea-pig heart. The extract is dried 

 upon filter-paper, as has been recommended for the hemolytic 

 amboceptor, and titrated according to the size of the square 

 of paper needed, instead of the quantity of fluid to be added. 



(4) The Corpuscle Suspension. For this purpose either 

 normal human corpuscles or the corpuscles of the patient 

 whose blood is to be examined may be employed. Instead of 

 a 5 per cent, suspension a i per cent, suspension is recom- 

 mended. If normal corpuscles are employed, it is necessary to 

 wash them free of the normal serum or plasma, which Noguchi 

 accomplishes as follows: 8 c.c. of normal salt solution are 

 placed in a large test-tube, and the blood flowing from a punc- 

 ture (in the operator's own finger, for example) permitted to 

 drop in, the proportion being i drop to each 4 c.c. The fluid 

 is then shaken and stood on ice over night, when the corpuscle 

 sediment and the supernatant fluid containing the fibrin 

 factors and ferment is decanted and replaced by fresh salt 

 solution, and the suspension made by shaking. Or, in a 

 laboratory, the corpuscles can be washed as usual with the 



