METHODS FOR CONDUCTING THE SYPHILIS REACTION 441 



bottom of the tube. As stated elsewhere, this method is not an 

 accurate measure of the amount of syphilis antibody, but constitutes 

 a relative and convenient gage of value within certain limits. In 

 reporting reactions to the clinician, the plus signs should not be used, 

 or if used, should be interpreted by the terms " strongly positive," 

 " weakly positive, " etc. 



TECHNIC OF THE SECOND METHOD 



Practically the same technic is used in this as in the first method, 

 except that three different antigens, instead of one, are used with each 

 serum, for the reasons previously stated. 



This method is to be strongly recommended, as it is simple, ac- 

 curate, and reliable. Although a little more work is demanded and 

 a larger quantity of the various reagents is required, the results 

 warrant the expenditure of a little more labor, and the second ob- 

 jection is readily overcome by using half the quantities prescribed 

 in the original Wassermann technic, as given in the first method. 



1. I generally use the following three antigens: (1) A cholesterin- 

 ized alcoholic extract of human heart; (2) alcoholic extract of syphil- 

 itic liver; (3) acetone-insoluble lipoids. 



As previously stated, these extracts are used in amounts equal to 

 from two to four times their titrated antigenic unit, providing these 

 doses are at least four times smaller than the anticomplementary 

 units. The amount of each antigen required for the work at hand 

 is calculated, placed in test-tubes, and slowly diluted with the 

 requisite amount of salt solution to secure maximum turbidity of the 

 emulsions. 



2. The complement is diluted 1 : 20 and is used in doses of 1 c.c.; 

 sheep's corpuscles are made up into a 2.5 per cent, suspension, and 

 used in doses of 1 c.c.; antisheep amboceptor is titrated as in the first 

 method, and used in doses equal to lJ/ units; serums are heated to 

 55 C. for half an hour, and used in doses of 0.1 to 0.2 c.c.; cerebro- 

 spinal fluid is used unheated in amounts of 0.8 c.c. 



The Test. For each serum four test-tubes are arranged in a row 

 and marked with the patient's name or initials. The first tube is 

 marked "C. H.," and receives the cholesterinized heart extract; the 

 second tube is marked "S" for the alcoholic extract of syphilitic 

 liver; the third is marked "A" for acetone-insoluble lipoids, and the 

 fourth is not marked at all or simply marked with the letters "S. C." 

 (serum control). 



