373 



Factors in the Interpretation of the Inhibitive and Fixation 

 Serum Reactions in Pulmonary Tuberculosis. 

 By Alfred H. Caulfeild, M.B. 



(Communicated by Prof. T. G. Brodie, F.B.S. Received August 24, — 

 Read November 2, 1911.) 



(From the Pathological Department of the National Sanatorium Association, 

 Gravenhurst, Canada.) 



Calmette and Massoll* have reported that immunisation of a calf with 

 " bacillen-emulsion " has produced, not complement-fixation bodies, but an 

 inhibitive effect which they designate as an " inhibiteur." Previous to this 

 theyf had reported upon a serum, obtained by intravenous inoculation, which 

 had an extremely active agglutinating property, and under certain conditions 

 was capable of precipitating various solutions of tuberculin. The reaction of 

 fixation was not, however, obtained with either the serum or the serum 

 precipitate. Independently I had observed a somewhat analogous serum 

 reaction (inhibitive reaction) in certain cases of pulmonary tuberculosis, and 

 I first reported this at the meeting of the Canadian Medical Association, 

 Toronto, June, 1910, subsequently publishing more extended investigations^ 

 along these lines. 



These reactions have become an additional aid in the clinical estimation§ 

 of the type of case. Emery|| records an observation which he regards as 

 similar in character to that of Calmette and Massol. The variations in 

 technique at present, however, prevent one from drawing any very close 

 comparisons. 



The complement negation phenomenon (inhibitive reaction) becomes 

 more easily demonstrated if one employs a series of antigen dilutions which 

 range, with salinelT replacing the serum unit, from one producing a full 



* Calmette et Massol, "Sur une Nouvelle Reaction Masquant dans les Serums la 

 Presence d'Anticorps Tuberculeux," 'Bull, de la Soc. de Biol.,' 5 fev., 1910. 



t Calmette et Massol, ' Sur la Precipitation des Tuberculines par le Serum d'Animaux 

 immunises contre la Tuberculose.' 



X Caulfeild, " Investigations on Pulmonary Tuberculosis," ' Journ. Med. Research," 

 vol. 24, No. 1. 



§ Caulfeild, "Correlation of Clinical Progress with the Results of Immunological 

 Studies in Pulmonary Tuberculosis," 'Archives of Internal Medicine,' October, 1911. 



|| Emery, "The Immunity Reaction in Diagnoses, especially of Tuberculosis and 

 Syphilis," 'Lancet,' 1911, vol. 1, p. 485. 



IT When the word saline is used, physiological saline solution is meant (0"85 NaCl in 

 distilled water). 



