428 Syphilis 



A The fresh organs, especially the liver, of a congenitally syphil- 

 itic fetus are ground finely and extracted with physiological 

 salt solution and filtered. This extract contains the soluble 

 constituent of the organs used, and the endotoxin of such 

 spirochsetes as have comminuted and the bodies of others. 



B. The cerebro-spinal fluid of the patient suspected to have 



syphilis is secured and heated to 56 C. to destroy any com- 

 plement it may contain. 



C. Fresh guinea-pig serum is secured, so that the complement it 



contains may be available for the test. 



When A, B, and C are mixed, the syphilitic amboceptors or immune 

 bodies in the cerebro-spinal fluid are caught by the receptors in the 

 microorganism al substance in the organ emulsion, and fixed, and the 

 complement in the normal guinea-pig serum united with the immune 

 elements, also fixed. Thus there is no longer any free complement in 

 the mixture. It is now necessary to take measures to find out whether 

 or not the complement is fixed, and to do this it is recommended that a 

 hemolytic experiment be performed. This is accomplished thus: 



a. A hemolytic serum i. e., one prepared by injecting an animal 

 with the defibrinated blood of another animal is prepared by heating 

 to 56 C., so that its complement is destroyed. 



b. The washed blood-corpuscles of the animal for whose corpuscles 

 the hemolytic serum is potent are ready in 5 per cent, suspension. 



c. The mixture of A, B, C already made. 



When a, b, c are mixed, the absence of hemolysis shows that the com- 

 plement in C has been caught by the anchored amboceptor affinities 

 in B, and their combining powers satisfied, so that the addition of the 

 hemolytic amboceptors in a can no longer activate them to dissolve the 

 appropriate corpuscles in b. Such a fixation of the complement being 

 possible only when the specific amboceptors are present is regarded as 

 pathognomonic of syphilis. A negative reaction does not always mean 

 that the patient has not syphilis, for in active stages of the disease there 

 may not yet be sufficient antibody formation to produce fixation of the 

 complement. 



Wassermann and Plaut were able to demonstrate the 

 antibodies in the spinal fluid of 32 out of 41 paretics; and 

 Schiitze obtained positive results in 8 cases of tabes in 

 which a history of syphilis was obtainable, and negative 

 results in 4 cases in which there was no such history. 



The technical difficulties are so great as to make it 

 doubtful whether the method can ever come into general use. 



Noguchi* has suggested a simplified method of preparing 

 the materials for making this test, and for keeping them in 

 such form as to be constantly and immediately available. 



It is, however, a cumbersome method and something 

 more simple is desirable for clinical use. 



Levaditi and Yamanouchif found that the antigen in the 

 organs of congenitally syphilitic infants is soluble in alcohol, 

 in which it keeps far better than in the normal saline solu- 



* "Jour, of Experimental Medicine," March, 1909, xi, 2, p. 392. 

 f "Compt. rendu de la Soc. de Biol. de Paris," 1907, t. xxxvm. 





