222 The Philippine Journal of Science 1923 



possible. The public-health officer under these circumstances 

 is confronted with the question whether treatment may be dis- 

 continued, when a clinical cure is effected, without danger of 

 an undue percentage of recurrences, and it may be properly 

 asked whether the Wassermann test can be of any service in 

 reaching an answer to this question. 



With such problems in mind several cases in the acute 

 secondary stage of yaws were investigated with reference to 

 the complement-binding strength of titrated sera by means of 

 the Wassermann reaction before treatment and clinical cure, 

 and at intervals afterward, and where possible until they became 

 negative. 



Only one satisfactory observation bearing on the duration of 

 the Wassermann reaction after treatment was found; namely, 

 the single case, reported by Shamberg and Klauder,(8) of an 

 American soldier who contracted the disease in France. The 

 test was frequently repeated over a period of six months, during 

 which time the patient received three intravenous injections of 

 neosalvarsan, 0.9 gram each. At the end of two months the 

 reaction had begun to weaken, and after six months was negative 

 with alcoholic extract of syphilitic liver, acetone insoluble anti- 

 gen, and almost so with cholesterized antigen. No one appar- 

 ently has measured the complement-binding strength of titrated 

 sera from yaws patients either before or after treatment. 



Twenty-three young Filipinos, all presenting fresh cutaneous 

 yaws, were selected for study. On twelve of these it has been 

 possible to repeat the Wassermann test at intervals over a period 

 of several months. 



METHOD 



The Wassermann test was performed according to the details 

 described by Hinton.(4) In the hemolytic system two units of 

 antisheep amboceptor, 0.5 cubic centimeter of a 5 per cent suspen- 

 sion of washed sheep-cells brought to the original volume of 

 whole blood, and two units of guinea-pig serum complement were 

 used in each test. The uniformity of sheep-cell suspension was 

 controlled by a color standard, and sera from several pigs were 

 pooled to obtain a complement of uniform strength. A maximum 

 of 0.1 cubic centimeter of patient's heated serum was used in 

 each test and a control of 0.2 cubic centimeter, for anticomple- 

 mentary action. Only one antigen was employed, instead of 

 three as practiced by Hinton. Most of the tests were made with 

 cholesterinized alcoholic extract of guinea-pig's heart used in 



