388 VENOM HEMOLYSIS 



PRACTICAL VALUE OF THE VENOM TEST IN SYPHILIS 



1. While the test is much simpler than the Wassermann reaction and 

 there is less possibility for errors in technic to creep in, it possesses but 

 two other advantages, namely: (1) It may react positively in latent 

 or tertiary syphilis when the Wassermann reaction may be negative, and 

 (2) it may react positively in treated syphilitic cases when the Wasser- 

 mann reaction is negative, and thus point to a continuation of treatment. 

 Corson- White and Ludlum 1 found 94 per cent., Schwartz 2 69.3 per cent., 

 and Stone and Schottstaedt 3 90.9 per cent, of positive reactions in the 

 active stages of syphilis. 



2. The test is positive in but about 20 per cent, of cases of tabes 

 dorsalis and general paralysis (White and Ludlum), a finding obviously 

 inferior to the Wassermann reaction. 



3. During primary syphilis the cells are hypersensitive and positive 

 reactions are but occasionally obtained. 



4. Positive reactions may occur in cancer, but otherwise the test is 

 quite specific, and may, in selected cases, prove a valuable adjunct to the 

 Wassermann reaction. However, with a more improved technic in 

 performing the Wassermann reaction, and especially if antigens re- 

 enforced with cholesterin are used, the venom test is inferior to the 

 Wassermann. In cases where syphilis or tuberculosis of the lungs is 

 to be differentiated, a negative venom test would indicate tuberculosis, 

 as in this disease the cells are hypersensitive. 



THE PSYCHO-REACTION OF MUCH 



Normal serum, when added to a lytic dose of cobra venom and human 

 red blood-cells, will not interfere with hemolysis. According to Much 

 and Holzman, 4 however, if the serum obtained from a patient suffering 

 from depressive mania or dementia prsecox is added to the mixture of 

 venom and human red blood-cells, the expected hemolysis does not take 

 place. 



Technic. A 1 : 5000 dilution of cobra venom is prepared by diluting 

 1 c.c. of the stock dilution (p. 385) with 4 c.c. of normal saline solu- 

 tion. Enough of the patient's blood is collected from a vein at the elbow 

 to yield at least 1.5 c.c. of serum; hea,t the serum to 55 C. for an hour. 

 Prepare a 5 per cent, suspension of washed human blood-cells. An effort 



1 Jour. Nervous and Mental Diseases, 1910, xxxvii, 721. 



2 New York Medical Journal, 1912, xcv, 23. 



3 Archiv. of Int. Med., 1912, x, 8. 4 Munch, med. Wochenschr., 1909, 20. 



