THE WASSERMAN REACTION. 



339 



heatedior thirty or sixty minutes respectively. If this is confirmed, an improved 

 technique in this direction may result for the investigation of the sera of treated 

 cases. We note in his table of results (7) the statement that of 151 cases of 

 secondary syphilis, 136 were positive ; 15 were negative, and, in a footnote, he 

 says that 13 of these negative ones had received at least one course of inunctions 

 or injections. 



The following is a list of our twenty eases which gave a positive 

 Wasserman reaction. 



Twenty cases showing positive Wasserman reactions. 



Num- 

 ber of 

 cases. 



Clinical condition. 



Num- 

 ber of 

 cases. 



Clinical condition. 



5- 

 7 

 3 

 2 



Syphilis secondary. 

 Syphilis tertiary. 

 Leprosy. 

 Yaws. 



1 

 1 

 1 



1 

 Dementia prsecox. 



Periostitis, chronic. 



Rheumatism, acute articular 



(probably syphilitic). 



The small percentage of positive results obtained by us in cases of 

 leprosy was referred to briefly in the last quarterly report of the Board. 

 We stated then that 18 out of 31 cases were negative, and that of the 

 three positive, one gave a clear history of syphilis of seven years' duration. 

 The two remaining positive cases passed from observation and we unfortu- 

 nately were unable to make inquiry from them as to the existence of 

 syphilitic infection or infection with yaws at some previous time. 



Wechselmann and Meier (8) have recorded one case of leprosy in which the 

 reaction was positive, using extract of syphilitic liver. The case had originally 

 been considered syphilitic, but later lepra bacilli were demonstrated in the lesions. 



Eitner,(9) after having obtained a positive reaction in a case of leprosy with 

 a watery extract of leprous tissue, later secured in a second case a positive 

 reaction using as an antigen an alcoholic extract of normal guinea-pig heart. 



Cases referred to frequently in the literature are tliose of Slatineanu and 

 Danielopolu.(lO), (11) Their first report referred to 26 cases of leprosy examined 

 by means Of leprous antigen and of these 20 were completely positive and 4 

 more were reported positive, although the complement fixation was less com- 

 plete. With alcoholic extract of syphilitic liver their results were different. 

 Of 21 cases examined, 11 were "completely positive," 5 apparently less so, and 

 the remainder negative. At present the general tendency of workers on the 

 Wasserman reaction is to deal with positive and negative reactions only, al- 

 though occasionally the importance of partial reactions is emphasized. In this 

 connection we might add that almost invariably our results have been distinctly 

 positive or negative and only in rare instances has there been a partial arrest 

 of hsemolysis in negative eases. 



Baermann and Wetter, (12) working in Sumatra, found that there was about 

 7 per cent of manifestly syphilitic individuals present among their laborers 

 and that about 20 per cent of apparently healthy workmen gave a positive 

 Wasserman reaction. Their percentage of positive reactions in leprosy varied 

 between 50 and 65 per ceiit, the difference depending upon the type of leprous 

 lesions present. Syphilitic antigen was used in their tests. 



104912 6 



