A text-book of medical diagnosis / by James M. Anders and L. Napoleon Boston ; with 418 illustrations in the text and 25 plates, 17 of them in colors.

  • Anders, James M. (James Meschter), 1854-1936.
Date:
1911
Catalogue details

Licence: In copyright

Credit: A text-book of medical diagnosis / by James M. Anders and L. Napoleon Boston ; with 418 illustrations in the text and 25 plates, 17 of them in colors. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    1202/1276 (page 1144)
    black ink, which, when placed behind the control, will appear as a clear black line, whereas the positive tube will not show the black line, or it appears as a dim shadow—depending upon the strength of the reaction. It has been stated that a positive Noguchi test and a negative Wasser- mann is often due to the presence in the patient's serum of antisheep ambo- ceptors. It is not necessary to perform this test with every serum as a con- trol. Only sera giving the above results need be subjected to a verification. To demonstrate the antisheep amboceptor, place 1 c.c. of a 5 per cent, sus- pension of sheep cells in a test-tube, add 0.2 c.c. of patient's serum and 0.1 c.c. complement, add 3 c.c. of NaCl solution, place in incubator, and observe. If the amboceptor is present, the cells will dissolve and the mixture become transparent. The time consumed depends upon the number of amboceptor units present. Kaplan observed sera capable of hemolyzing the cells com- pletely in ten minutes. Rationale of Controls.—In the Wassermann and Noguchi reac- tions it is of vital importance to have every possible error excluded. For this purpose the controls used will answer. The substances to be controlled are the antigen, the amboceptor, and each individual serum. The Antigen Control.—This biologic reagent, as is known, can per se inhibit hemolysis. To measure the degree of such interference, a tube con- taining a well-known normal serum (or, as Kaplan found just as serviceable, no serum at all), plus antigen, plus complement, and antisheep amboceptor plus sheep cells ought to hemolyze in about twenty or thirty minutes. No reaction is to be considered as finished before the antigen control tube is completely hemolyzed. The Amboceptor Control.—Upon the efficiency of the antisheep ambo- ceptor depends the rapidity of hemolysis of the sheep cells. It is therefore necessary to establish the amboceptor efficiency in a separate tube containing sheep cells, plus complement, plus antisheep amboceptor. It is not essential to add normal serum. The tube containing the above ingredients is always the first to hemolyze, requiring about fifteen or twenty minutes for a com- plete hemolysis. Control for Each Serum.—Every serum more or less has the power to interfere with hemolysis to a slight degree. In order to control the factor of inhibition, every semm tested is placed in each of two tubes; the front tube contains the antigen and all other biologic reagents, the rear tube receives everything but the antigen. This shows the degree of individual inhibition as compared with the tube containing the amboceptor control. Efficiency of the Entire System.—For this a well-known luetic serum is utilized. The reaction is to be positive, and hemolysis should not occur in the front tube, even if exposed to incubation temperature for hours after the controls hemolyzed.