jan. a, 1917 Diagnosis of Tuberculosis by Complement Fixation 3 
witz (30) were the first who disagreed with their conclusions. Citron, 
while agreeing with the principles of the Wassermann-Bruck conception, 
continued the investigations for the purpose of determining whether it 
would be possible to establish antibodies in the blood of tuberculous 
individuals, though they were not treated with tuberculin. Employing 
Wassermann's method, he obtained in 9 untreated cases of tuberculosis 
2 positive and 7 negative results; whereas in 14 treated cases, 8 were 
positive and 6 negative. Ludke (27) also confirmed the essentials of the 
Wassermann-Bruck work, as he found antituberculin present in tuber¬ 
culous tissue in man in 3 out of 5 cases. He also found it in the serum 
in 17 out of 31 treated cases and in 2 advanced cases out of 10 untreated 
cases. In 18 cases, none of which were tuberculous, negative results 
were obtained in all instances. Ludke also observed that antituberculin 
was present, especially in cases where the administration of tuberculin 
was not followed by a systemic reaction. In the cases in which this injec¬ 
tion was followed by a reaction he failed to obtain any fixation. In 8 
cases tested both before and after the administration of tuberculin anti¬ 
bodies were found in 7 after injection. In 3 cases affected with diseases 
other than tuberculosis the injection of tuberculin was not followed by 
the appearance of antituberculin. 
Wolff-Eisner (42) denied the specificity of the reaction because they 
found that the serums of patients suffering from pneumonia, typhoid 
fever, or lues gave a similar reaction to those affected with tuberculosis. 
Laub and Novotny (23) also questioned the usefulness of the reaction, 
as they found that the results were very irregular, tuberculous patients 
giving the same proportion of reactions as healthy individuals. Cohn 
(13), on the other hand, established the usefulness of the reaction, pro¬ 
vided the test is carried out with the utmost care, including the use of 
all controls, in which case the presence of antibodies may be demonstrated 
not only by the tuberculin-treated individuals but also in progressive 
cases. A number of investigators, as M, Wolff and Muhsam (41), Czastka 
(15), Bermbach (2), Weil and Strauss (39), claimed to have been able to 
obtain favorable reactions in 20 to 50 per cent of their tests. On the 
other hand, the followers of Escherich (20) declared that at no time was it 
possible to determine antibodies in tuberculous children. Schlossmann 
(34) and Engel and Bauer (19) confirmed these views. Engel and Bauer, 
investigating a series of tuberculous affections in children, failed to find 
specific antibodies either in the serum of healthy or in infected children. 
In all cases of tuberculosis which were specifically treated, antibodies devel¬ 
oped. They further found that the antibodies increased in proportion 
to the injections of tuberculin and diminished after discontinuing the 
treatment. Frugoni (21) and Szabdky (36) also concluded that the 
complement fixation in tuberculosis is of no value for diagnostic pur¬ 
poses, which view was also held by Bach (1) with regard to animal tuber¬ 
culosis. 
