Recent literature on syphilis : with special reference to serodiagnosis and treatment.

Date:
1911
Catalogue details

Licence: Public Domain Mark

Credit: Recent literature on syphilis : with special reference to serodiagnosis and treatment. Source: Wellcome Collection.

Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.

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    large quantity. It is not infrequent that a crude alcoholic extract is so hemolytic that it cannot be tested for the antigenic strength. Contrasted with the aqueous and alcoholic (unfractionated) extracts the aceton-insoluble lipoids are usually non-hemolytic and only slightly anticomplementary, if at all. The antigenic property is strikingly strong with the majority of the preparations of these lipoids. As there are certain specimens which are exceptional to this, it becomes necessary to make selection of a suitable one by the method already outlined. For the technical details the reader is referred to my work^ which has just ap- peared. In concluding this topic, I may mention the fact that, in the standard of suitable antigen for the Wassermann, the difference between the anti- complementary and antigenic doses of the extract is 2:1 or more (un- determined), while in my method the difference between the two is, at least, 20:1 ]-^=^20. Concerning the Estimation of the Strength of Reaction.—When the com- plement is completely fixed by the syphilitic serum and antigen, it is said to be positive or, according to certain investigators, strongly positive. But, who knows whether the same is caused by just that quantity of syphilitic antibody sufficient to fix that amount of complement or by a considerable excess of the antibody, unless a further analysis is made. In the Wassermann method Citron introduced a method by which he aimed to estimate the strength of the reaction. His idea is to combine two different quantities (0.2 c.c. and 0.1 c.c.) of the patient's serum with two different quantities (0.2 c.c. and 0.1 c.c.) of antigen extract. When complete inhibition occurs with the smallest amount of patient's serum and that of the antigen, it is recorded + + + +, etc., until an im- perfect inhibition with the largest quantity of both is designated as +' or doubtful reaction. He divides the intensity into + + + +, + + +, ^ +' +' J: I have met with such specimens of sera which gave still complete fixation in quantities as small as 0.0006, 0.001, 0.005, etc. The smallest quantity used in Citron's estimation is 0.1 c.c. and is quite in- adequate to measure the strength of a stronger specimen than that gives the positive reaction in 0.1 c.c. Another point of un- certainty in this scheme is that the number of the antigenic units in a given volume of the extract can vary so greatly that a uniform result comparable with one another is scarcely to be hoped for. Again, with regard to estimating a weaker reaction, it is not to be overlooked that the variations in the amounts of the amboceptor in each specimen alone can bring about any degree of reaction, without any relation to the actual amount of the so-called syphilitic antibody contained in the serum. In other words, the same amount of the antibody may give ■• + ^ +, + + +, + -h, +, +, or—, depending upon the amount of the natural antisheep amboceptor. 1 Serum Diagnosis of Syphilis, Second Edition, 1911. (Lippincott & Co., Philadelphia.)