58() 
TREPONEMATA, SPIRONEMATA, LEPTOSPIRATA 
The following statistics of German, English and American investi- 
gators are ilhistrative of the probable frequence of positive reactions 
(Wassermann) in primary, secondary, tertiary and latent syphilis. 
Moderately positive reactions are recorded as positive; feebly positive 
reactions are regarded for statistical purposes as negative. These 
results are based upon careful comparisons with the clinical diagnosis 
in each instance. 
Primary. 
Secondary. 
Tertiary. 
Latent. 
Cases. Positive. 
Cases. Positive. 
Cases. Positive. 
Cases. 
Positive. 
10601 629 
1371 99 
1832 1 139 
333 31 
1320^ 780 
9086 813 
3526 3101 
747 729 
407 384 
109 188 
3500 3425 
1889 1817 
1221 
167 
51 
195 
510 
638 
1020 
155 
48 
190 
502 
558 
983 
548 
39 
11,500 
1,173 
504 
230 
18 
5300 
790 
3641 249] 
10,178 9644 
2773 
2473 
14,243 6842 
1 
Control cases 1927, of vi^hich 5 were positive. 
4. Luetin reaction.^ 
Preparation of Luetin.— A culture of Treponema pallidum is ground 
until the organisms are thoroughly disrupted, then heated to 60° C. 
for an hour and suspended in sterile salt solution to which is added 
0.5 per cent carbolic acid as a preservative. The reaction induced 
in syphilitics is essentially like the tuberculin reaction. It consists 
in the development of a vesicle or a pustule at the site of inoculation 
with temperature and pain. The control inoculation should exhibit 
but a slight reddening. The reaction is specific, except for old, 
advanced cases, where the reaction may fail. It is most marked in 
the later tertiary and congenital cases where serological reactions are 
said to be more likely to be negative. 
Colloidal- gold or Lange Test.— Spinal fluid, which should be perfectly 
clear, is obtained in the usual manner, by spinal puncture. At least 
0.5 cc. should be obtained. 
The Test. —A row of 11 clean, dry test-tubes (10 x 0.5 cm.) are 
placed in a rack. To the first add 1.8 cc. of 0.5 per cent sterile normal 
salt solution (made freshly with conductivity water). To the remain- 
ing tubes add 1 cc. of 0.4 saline solution. 
1 Boas: Die Wassermannsche Reaktion mit bes. Beriicksichtigung ihrer klinischen 
Verwertbarkeit., II Aufl., Berlin, 1914. 
- Bassett-Smith: British Med. Jour., 1910, ii, 14.34. 
3 Fildes and Mcintosh: Brain, 1913, 36, 193. 
*• Muller: Die Serodiagnose der SyphiHs und ihre Bedeutung flir die Diagnose, 
Therapie und Prognose, Wien., 1913. 
' Craig: Am. Jour. Med. Sci., 1915, 149, 41. 
» Noguchi: .lour. Exp. Med., 1911, 13, 557. 
