798 Syphilis 



action in assisting the diagnosis of tuberculosis led to ex- 

 periments on the part of a number of investigators Mei- 

 rowsky, Wolff-Eisner, Tedeschi, Nobe, Ciuffo, Nicholas, 

 Favre, and Gauthier and Jodasshon to obtain analogous 

 reaction in syphilis by applying extracts of syphilitic tissues 

 to the scarified epiderm of syphilitics. Some reactions were 

 observed, but Neisser and Bruck found that similar reactions 

 occurred when a concentrated extract of normal liver was 

 applied, and to such reactions which could not be looked upon 

 as specific, Neisser applied the term " Umstimmung." 



After having successfully achieved the cultivation of Tre- 

 ponema pallidum, Noguchi* resolved to try the effect of an 

 application of an extract of the organisms applied to the skin, 

 in the hope that it might provoke a reaction useful for diag- 

 nosis. To this end he prepared two cultures, one in ascitic 

 fluid containing a piece of sterile placenta, the other in ascitic 

 fluid agar also containing a piece of placenta. After per- 

 mitting them to grow under strictly anaerobic conditions at 

 37 C. until luxurient development occurred, the lower part 

 of the solid culture was carefully cut off, the tissue fragment 

 removed, and the rich culture carefully ground in a sterile 

 mortar, the thick paste being diluted from time to time by 

 adding a little of the fluid culture. The grinding was con- 

 tinued until the emulsion became perfectly clear, when it 

 was heated to 60 C. for one hour upon a water-bath and 0.5 

 per cent, of carbolic acid added. When examined with the 

 dark-field illuminator, 40 to 100 dead treponemata could be 

 seen in every field. Cultures made from the suspension re- 

 mained sterile and inoculation into rabbits' testicles was with- 

 out result. 



This extract of the treponema cultures he calls luetin. 

 When it was applied to the ear of a normal rabbit, by means of 

 an endermic injection with a fine needle, an erythema ap- 

 peared, but faded within forty-eight hours, the skin resuming 

 its normal appearance, but when it was applied to the ear of a 

 syphilized rabbit, at the end of the forty-eight hours the red- 

 ness developed into an induration the size of a pea and per- 

 sisted from four to six days, disappearing in ten days. In one 

 case a sterile pustule developed. 



Luetin was tested by Noguchi and his colleagues upon 400 

 cases: 146 of these were controls, 177 syphilitics, and 77 

 parasyphilitics. In the controls there was erythema without 

 * "Journal of Experimental Medicine," 1911, xm, p. 557. 



