Diagnosis 429 



tion. When this alcoholic extract of the congenitally syphil- 

 itic liver was analyzed to determine its chemical composi- 

 tion, it was found to contain bile-salts, lipoids, and lecithin. 

 Upon testing to see what influence these chemical com- 

 pounds might have upon the reaction, it was found possible 

 to obtain it by the addition of i per cent, solution of 

 taurocholate and glycholate of sodium, and with solutions 

 of lecithin, so that these substances seem able to replace 

 the antigen of the syphilitic liver, and thus simplify the test. 



These observations fully accord with those of von Diin- 

 gern, who found that cytolysis might not only be produced 

 by the specific bodies but also by bodies chemically closely 

 related to them. 



Klausner* has suggested a method of testing syphilitic 

 blood that is based upon the varying globulin content as 

 compared with normal blood. The method, which is ex- 

 ceedingly simple, consists in placing 0.2 cc. of the serum to 

 be examined in a small test-tube and adding 0.7 cc. of dis- 

 tilled water. At the same time a similar dilution is made 

 with normal serum. In the course of a few hours the 

 syphilitic serum will be found to have deposited many 

 small flocculent masses which gradually sink to the bottom 

 of the tube. At the end of fifteen to twenty hours there 

 is considerable precipitate in the syphilitic serum, little in 

 the normal serum. It is at this time that the comparison 

 must be made, as often this same amount may be found 

 in both tubes. A similar precipitate, however, takes place 

 in other conditions, such as typhoid and pneumonia, though 

 by increasing the dilution it can always be shown that there 

 is a greater quantity of precipitate formed in the syphilitic 

 serum. 



Forges and Meier f found that the sera of syphilitics was 

 readily differentiated from normal serum by the more rapid 

 appearance of a more abundant precipitation than occurred 

 in normal serum when a i per cent, solution of lecithin was 

 added to it. 



Nobl and ArztJ showed that sodium oleate, and Pitz and 

 Kren that sodium glycocholate, gave the same reaction as 

 lecithin. 



*" Wiener klin. Wochenschrift," 1908, xxn, 214, 363. 

 f "Berliner klin. Wochenschrift," 1907, XLIV, 1634; "Wiener klin. 

 Wochenschrift," 1908, xxi, 206. 



t "Wiener klin. Wochenschrift," 1908, xxi, 287. 

 Ibid., 1903, xxi, 386. 



