THE PSYCHO-REACTION OF MUCH 389 



should be made, if possible, to use as a control the cells of a person 

 which are known to be readily hemolyzed by 1 c.c. of the 1 : 5000 dilution 

 of venom in half an hour. 



Into a series of three small test-tubes place 0.4 c.c. of the patient's 

 serum and decreasing amounts of venom 1, 0.8, and 0.5 c.c. respectively. 

 Next add to each tube 1 c.c. of the blood-corpuscle suspension. The 

 total volume in each tube is brought up to 2.5 c.c. by the addition of 

 normal saline solution. 



A similar series of tubes should be set up as controls, the patient's 

 serum being omitted. The following table shows the arrangement: 



Tube 1: 0.4 c.c. serum + 1 c.c. venom + 1 c.c. blood. 



Tube 2: 0.4 c.c. serum + 0.8 c.c. venom + 1 c.c. blood. 



Tube 3: 0.4 c.c. serum + 0.5 c.c. venom + 1 c.c. blood. 



Tube 4: 1 c.c. venom + 1 c.c. blood. 



Tube 5 : 0.8 c.c. venom + 1 c.c. blood. 



Tube 6: 0.5 c.c. venom + 1 c.c. blood. 



Tube 7: 1 c.c. blood. 



The tubes are shaken gently and incubated for an hour at 37 C., 

 when a preliminary reading is made. If the control tubes 4, 5 and 6 

 are hemolyzed, a positive reaction would be indicated by the inhibition 

 of hemolysis in the first three tubes, 1, 2 and 3. Control tube 4 at least 

 should be completely hemolyzed at the end of half an hour, and in a 

 positive reaction tube 1, containing the same amount of venom with the 

 patient's serum, will show inhibition of hemolysis. 



Practical Value. Corson- White and Ludlum 1 have found the reac- 

 tion positive in 80 per cent, of cases of the catatonic form of dementia 

 praecox and in 62 per cent, of the hebephrenic type. Only 3 out of 37 

 cases of manic-depressive insanity reacted positively. Among controls 

 with serums of other diseases positive reactions were secured in one case 

 each of cerebrospinal syphilis, tertiary lues, exophthalmic goiter, and 

 confusional insanity, and in two cases each of general paralysis and 

 epilepsy. The afore-mentioned observers claim, however, that if the 

 venom is carefully standardized with blood-cells that are completely 

 hemolyzed in 1 : 5000 dilution of venom in thirty minutes, the reaction 

 possesses some diagnostic value, having been found, under these condi- 

 tions, to yield positive reactions in 87 per cent, of cases of dementia 

 prsecox and in 100 per cent, of cat atonies. 



According to Citron, the reaction is probably due to interference 

 with hemolysis by an increase in the cholesterin of the serum a pos- 

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



