Complement Fixation in Tuberculosis. 137 



positive fixations. Tubercle bacilli were not found in the sputum 

 from 16 of these cases. 7 of these 16 were suffering from the early 

 incipient type of the disease. 



"Stage two": We tested the sera of no such cases. All but 

 12 in this series had positive bacteriological proof of infection. 

 The fixation test was positive in all but 2 cases. 



"Stage three": 84 cases tested. One very advanced case gave 

 no fixation. The sputum was positive in all but one case. The 

 fixation test was positive in 83 of these 84 third-stage cases. 



We have, then, 226 patients suffering from clinically active 

 tuberculosis, in whom the test was positive in 223 cases. - 



The reaction was done with 88 sera from so-called healed 

 (arrested or inactive) cases. These were cases which, at one time 

 or another, had suffered from active tuberculosis but which were, 

 at present, apparently free from symptoms pointing to absorption 

 from any active focus. 54 cases were negative for the test; 13 

 cases were positive, however in 8 of these tubercle bacilli were found 

 in the sputum shortly before the test was performed; 21 cases 

 showed weak fixation. Here we have a group of 88 healed, or 

 better, arrested cases in which the reaction was negative in 54, 

 weak in 21 , and positive in 13, 8 of these 13 being cases with positive 

 sputa. 



Our next group consists of 140 doubtful cases where no diag- 

 nosis was established and where, obviously, no bacteriological 

 proof was present. 32 in this group gave positive fixation; 108 

 negative. In some of the 32 positive cases, a definite clinical 

 diagnosis of tuberculosis was subsequently established. In none 

 of the 108 negative cases has there been found, thus far, any 

 evidence of tuberculosis. This group of doubtful cases includes 

 84 pulmonary cases, 5 glandular cases (3 of which were diagnosed 

 as Hodgkin's disease. In one of the Hodgkin cases, the serum 

 report was + + + + . and an excised lymph node from this patient 

 turned out to be tubercular upon later pathological examination) ; 

 also there were 21 eye cases, I case of sepsis of the throat, and 12 

 miscellaneous cases. 



45 positive Wassermann sera were tested. 2 gave positive 

 fixation with the tubercle bacillus antigen. One of these two 

 cases was a dispensary patient who at present can not be followed 



