FIXATION OF COMPLEMENT 137 



mann reaction may be performed on cases of these dis- 

 eases by examination of either the blood-serum or the 

 cerebrospinal fluid. In using the latter for the test 

 inactivation is not necessary, as the fluid contains no 

 complement. The technic is the same as when using 

 blood-serum, except that 0.2 c.c. of the cerebrospinal 

 fluid should be employed. According to most ob- 

 servers, in paresis, examination of the blood-serum 

 shows the Wassermann reaction to be positive in prac- 

 tically all cases, while the cerebrospinal fluid gives a 

 positive result in about 90 per cent, of cases. 



In tabes both the blood-serum and the cerebro- 

 spinal fluid give a positive Wassermann reaction in 60 

 to 70 per cent, of cases. 



In the manifestations of syphilis of the central 

 nervous system, which do not differ materially from 

 syphilitic lesions elsewhere, and are grouped apart 

 from paresis and tabes, the Wassermann reaction with 

 the blood-serum is positive in practically all cases, 

 while it is positive in only a small percentage of cases 

 with the cerebrospinal fluid. In this group are in- 

 cluded gummatous lesions, syphilitic meningitis, etc. 

 From personal experience, we have found in general 

 that the cerebrospinal fluid is more frequently positive 

 or gives a stronger Wassermann reaction than the 

 blood-serum in the majority of cases of syphilis in- 

 volving the central nervous system. 



