302 IMMUNOLOGICAL METHODS OF DIAGNOSIS 



COMPARISON OF THE WASSERMANN AND NOGUCHI SYSTEMS (RESULTS 

 OBTAINED BY D. M. KAPLAN) 



As regards the relation of the Wassermann reaction to the treat- 

 ment of syphilis with salvarsan or salvarsan in combination with 

 mercury, the majority of syphilographers are in accord in demanding 

 that the treatment be continued until a permanently negative Wasser- 

 mann is obtained and maintained (see section on Salvarsan). This 

 standpoint is in accord with the view that the Wassermann reaction 

 is a reaction of infection and not of immunity, and that the existence 

 of infection may be inferred so long as the reaction is demonstrable. 



The rapidity with which the reaction disappears under treatment 

 is quite variable. I have thus obtained a persistingly negative result 

 already after a single injection of salvarsan, while in other cases the 

 salvarsan in itself, though given repeatedly, was not able to cause 

 the reaction to disappear, whereas this promptly occurred, if mer- 

 curial treatment was instituted in addition. For further details of 

 this order, however, I must refer the reader to special works. 



In this connection it is interesting to note that Noguchi has 

 recently compared the findings obtained with the Wassermann 

 technique, i. e., with the use of lipoid antigen, with the results 

 which were obtained, when a pure culture of spirochetes was used 

 as antigen. I append some of the more important conclusions to 

 which these investigations gave rise: "(1) The Wassermann reac- 

 tion is caused by lipotropic substances, but not by the antibodies 

 which combine specifically with the pallida antigen; (2) the fixation 

 produced by the culture pallida antigen with certain syphilitic sera 

 is caused by the specific antibodies contained in the latter and may 

 constitute a specific diagnostic method for syphilis; (3) the fixation 



