168 APPENDIX. 



positive reaction was obtained in an advanced case 

 of tuberculosis, but it was not possible to say 

 definitely that a syphilitic infection was not also 

 present. 



According to Noguchi, the Wassermann test occa- 

 sionally gives negative results in general paresis ; the 

 butyric acid test always gives a positive reaction, 

 giving results which agree perfectly with those 

 obtained by cytodiagnosis, and with the clinical 

 picture. Noguchi's test for spinal fluid can be 

 applied even to old specimens (a year old) with 

 equally good results as in fresh fluid. Wasser- 

 mann 's test requires fresh spinal fluid. Whether 

 this simple test can be substituted for the well- 

 tried Wassermann reaction can only be determined 

 by a large number of careful control experiments. 



