Butyric Reaction for Syphilis. 



53 



Spinal fluid derived from parasyphilitic cases gives a typical 

 reaction, becoming granular in a few minutes and sedimenting in 

 from lO to 15 minutes. Cerebro-spinal fluid from cases of congeni- 

 tal, tertiary or secondary syphilis gives quite constantly a positive 

 reaction, but the intensity is usually less and two hours may be 

 required before the characteristic granular appearance becomes 

 manifest. Cerebro-spinal fluid from cases of cerebral or spinal 

 syphilis gives invariably a positive reaction. Negative reaction 

 was obtained with the spinal fluid from cases of acute anterior 

 poliomyelitis, epilepsy, alcoholic psychosis, dementia precox, senile 

 dementia, spastic paraplegia, lobar pneumonia and typhoid fever. 

 On the other hand, an abundant flocculent precipitate was usually 

 formed with the spinal fluid from cases of tubercular menin- 

 gitis, influenza meningitis, or epidemic cerebro-spinal meningitis.* 

 Cerebro-spinal fluid collected from two cases of hydrocephalus 

 also gave abundant precipitation. In all of these acute inflamma- 

 tory cases, except one of hydrocephalus, the Wassermann reaction 

 was, however, negative. A number of post-mortem spinal fluids 

 were examined with such results that it seems desirable to use the 

 method as a routine diagnosis for syphilis or parasyphilitic affec- 

 tions at autopsy. In the spinal fluid of two monkeys with active 

 experimental syphilitic lesion at the site of inoculation, which per- 

 sisted about 6 months, the reaction was positive. 



Referring to the results of examinations of the blood serum, 

 it appears that the reaction is non-specific for syphihs, because a 

 similar reaction can be obtained in certain cases of tuberculosis, 

 carcinoma and Hodgkin's disease. 



In view of the constancy with which an abnormally high globu- 

 lin content attends the florid stage of syphilis and appears to be 

 present in an early primary stage, and is present in the late second- 

 ary and tertiary stages of imperfectly treated cases, one is thus en- 

 abled to follow the course of an anti-syphilitic treatment. Moreover 

 the butyric acid test is a more delicate indicator than the Wasser- 

 mann reaction, for the latter is very frequently negative in this latter 

 class of cases. Under conditions of adequate treatment, the globu- 

 lin fraction of the blood serum is not increased. A negative re- 



These acute inflammatory conditions are quickly and perfectly excluded by clini- 

 cal and usual microscopical methods of diagnosis. 



