466 THE TECHNIC OF COMPLEMENT-FIXATION REACTIONS 



genital lues, at least in some of these cases. In my own series of 250 

 cases examined by the Wassermann and Noguchi methods, with antigens 

 of alcoholic extract of syphilitic liver and acetone-insoluble lipoids, the 

 reactions were positive in 5 cases, or 2 per cent. Similar results have 

 been secured by Boas, Browning and Mackenzie, and others, so that it 

 may be said that the reaction in scarlet fever is uniformly negative. It is 

 also to be remembered that occasionally, or in about 1 to 2 per cent, of 

 cases, a positive reaction may follow ether or chloroform anesthesia, but 

 that this will later disappear. In pellagra Fox, and later Bass, have 

 found occasional positive reactions. 



Normal cerebrospinal fluid or the fluid from persons with ordinary 

 non-syphilitic diseases reacts negatively. Positive reactions have been 

 reported in leprosy and in frambesia. 



THE EFFECT OF TREATMENT UPON THE WASSERMANN REACTION 

 Citron originally observed that during the mercurial treatment of 

 syphilis the Wassermann reaction gradually became weaker, and finally 

 disappeared. He also found that treatment was best governed by the 

 serum reaction, and that it should be persisted in until a negative re- 

 action was secured. His observations have in the main been abundantly 

 confirmed by various observers the world over, although the extensive 

 series of observations now on record have given us a fuller understanding 

 of its principles. 



The Wassermann reaction is the most constant and delicate single 

 symptom of syphilis, and whenever a serum is found to react positively, 

 antisyphilitic treatment is indicated, and should be persisted in until 

 the reaction becomes negative and remains so for a sufficiently pro- 

 longed period of observation. It is now quite generally believed that 

 a persistently positive reaction indicates the presence of living spiro- 

 chetes, and that treatment should be continued until the blood reacts 

 negatively. The reports of observers from all parts of the world indi- 

 cate quite clearly and conclusively that the schematic, symptomatic, 

 intermittent, and hard and fast rules of treatment of former days are 

 not sufficient. They would also tend to show that the Wassermann 

 reaction is the most delicate symptom and the last to disappear, and 

 that treatment should be continued until this reaction disappears 

 entirely and permanently. {^It has been abundantly proved, however, that 

 in syphilis a single negative reaction is not sufficient or definite evidence 

 that a cure has been effected, for the disease may recur after treatment is 

 discontinued, at least to the extent that the Wassermann reaction reappears, 



