THYROID IN INFECTIOUS DISEASES 83 



patients with a primary induration are very satisfac- 

 tory for this kind of work. When, however, in a sus- 

 picious ulcer spirochaeta pallida is found we have no 

 right to wait with the abortive treatment till infection 

 is generalized. 



Now, I have treated five patients in whom no Spiro- 

 chetes were found and where later the Wassermann 

 test became positive and secondary symptoms devel- 

 oped, with the oral administration of thyroid extract 

 (50 milligrams of the dried gland, 3 times daily). Of 

 course there are other patients who have never devel- 

 oped secondary symptoms or a positive Wassermann 

 treated in the same way. They are not mentioned here, 

 as it never can be proved that they have been infected 

 with syphilis. As a control, I have used six only locally- 

 treated ulcers, which proved later on to be of syphilitic 

 origin. 



The Wassermann reaction is a modification of a test 

 invented by Bordet & Gengou. This reaction of Bor- 

 det & Gengou is a real reaction between antigen and 

 antibody. In the beginning, Wassermann and his co- 

 operators believed that the syphilis test was based on 

 the same principle. Though we cannot yet understand 

 the physicochemical process of the Wassermann test, 

 one thing is very probable : 



This test is not a simple reaction between antigen 

 and antibody, but rather is a test on a colloid-chemical 

 change in the serum [Walker (35), Holker (35)]. 

 The positive test may be considered as the first proof 

 of the generalization of the pathological procass. It is, 

 however, of the highest importance to diagnose the 

 syphilis before the Wassermann test is positive. Was- 

 sermann himself (37), has divided syphilis into two 

 periods : a pre- and a post- Wassermann period. In the 

 first period an abortive treatment is sufficient. In the 

 second period, treatment may take many years. Was- 



