METHODS FOR CONDUCTING THE SYPHILIS REACTION 463 



READING AND RECORDING THE WASSERMANN REACTION 



1. The hemolytic system control is inspected first. It should show 

 complete hemolysis, indicating that the complement and amboceptor 

 were active and have been used in sufficient amounts. If a few cor- 

 puscles are found in the bottom of the tube, some error in pipeting 

 has probably occurred, too many corpuscles or too little complement 

 or amboceptor having been introduced. 



2. The corpuscle control should show no hemolysis, indicating that 

 the solution is isotonic and that the corpuscles are not unduly fragile. 



3. The antigen control should show complete hemolysis, indicat- 

 ing that the dose used was not anticomplementary. If this tube 

 shows incomplete hemolysis, due to the anticomplementary action 

 of the antigen, all the front two tubes will also show some inhibition 

 of hemolysis, due to this non-specific complement fixation, and it is 

 necessary to repeat the tests with another extract. 



4. The rear tubes of all serums should be completely hemolyzed, 

 indicating that the serums were practically free from anticomple- 

 mentary action as previously stated, most antigens and serums are 

 usually very slightly anticomplementary if small amounts of com- 

 plement are used with a close single unit of amboceptor, but in this 

 technic the complement and two units of amboceptor are sufficient, 

 under ordinary circumstances, to offset this influence. If, however, 

 a serum is more than normally anticomplementary, the rear tube 

 will show some inhibition of hemolysis, and, of course, in the front 

 tube a similar inhibition, and probably to a greater degree, will be 

 seen. If the serum is very slightly anticomplementary and the 

 front tube shows complete inhibition of hemolysis, the reaction is in 

 all probability positive. If the rear tube, however, shows marked 

 inhibition of hemolysis, indicating that it is highly anticomplementary, 

 the result cannot be determined, but a retest with fresh serum must / 

 be made. This indicates the great importance of the "serum control," * 

 and it may be stated that a test should never be made without it. 



5. The front tube containing the known syphilitic serum should ^ 

 show inhibition of hemolysis, indicating that the extract possesses 

 antigenic properties. 



As the complement is "fixed" by the syphilis antibody and ex- 

 tract, hemolysis could not occur when the corpuscles and amboceptor 

 were added. If a portion of the complement is fixed by antibody and 

 extract, then the unfixed portion will hemolyze some of the corpuscles, 

 the reaction being moderately positive, slightly positive, etc., depend- 



