THE WASSERMANN REACTION IN SYPHILIS 403 



methods and attempt to discover if luetic antigen could be demonstrated 

 in the serums of luetics through complement fixation. Antigens pre- 

 pared of the red corpuscles of syphilitic persons gave positive reactions 

 with the serums of highly immunized monkeys. Of 160 luetic patients, 

 in 70 per cent, either antigen or antibody was found. Later, however, 

 Citron showed that the extracts of corpuscles of normal persons yielded 

 similar results, which, in the light of subsequent discoveries, was due to 

 their content in lipoidal substances. 



Up to this time the syphilitic reaction was considered as but a simple 

 and direct application of Bordet's phenomenon, requiring a specific 

 syphilitic antigen before complement could be fixed with the syphilis 

 antibody. In January, 1907, Weygandt reported that he had obtained a 

 positive reaction in tabes with an extract of normal spleen. Marie 

 and Levaditi, using an aqueous extract of normal fetal liver, secured 

 positive reactions with the cerebrospinal fluid of paretics, but observed 

 that it was necessary to use larger doses than when extracts of syphilitic 

 organs were used. Subsequently other investigators, as, for example, 

 Fleischmann, Michaelis, Landsteiner, and Plaut, found that watery 

 extracts of normal organs served to fix the complement with luetic 

 antibody. Finally, in December, 1907, a profound impression was cre- 

 ated by the discovery made by Landsteiner, Miiller, and Potzl, that an 

 alcoholic extract of guinea-pig heart yielded results equal to those 

 obtained with an aqueous extract of syphilitic liver. These results 

 indicated that the antigenic principle was soluble in alcohol, and a pro- 

 longed series of investigations on the various lipoids and their relation 

 to the reaction was begun. These included the employment of leci- 

 thin by Porges and Meier; sodium taurocholate and glycocholate by 

 Levaditi and Yamonouchi; cholesterin and vaselin by Fleischmann; 

 oleic acid by Sachs and Altman; acetone-insoluble fractions of alcoholic 

 extracts by Noguchi; and many other combinations of various lipoidal 

 substances by different investigators. 



These dealt a blow to the theory of the Wassermann reaction, which, 

 taken in conjunction with the wide-spread use of the test by inexperi- 

 enced and unskilful persons and the many sources of error, tended to 

 retard an earlier appreciation of the great value of the test, and served to 

 swing the pendulum of medical opinion so far in the wrong direction that 

 it is only now, with a better understanding of its possibilities and limita- 

 tions, that the method is being established in its proper sphere. Posi- 

 tive reactions were said to have occurred in frambesia, leprosy, malaria, 

 pellagra, pneumonia, scarlet fever, typhoid fever, malignant tumors, and 



