Further Studies Upon the Complement Fixation Test in Chronic Gonorrhea in Women

Abstract

Summary Investigation of various media for the preparation of gonococcus antigen showed that any of the starch-free and hemoglobin-free media that would give a profuse growth of the gonococcus within forty-eight hours at 37°C. would give antigens of equal value. Recently isolated gonococci were of lower antigenicity than the Torrey strains isolated many years ago. Autogenous antigens gave no stronger reactions with their homologous serums than did the Torrey strain antigen. In this study we have encountered very few anticomplementary patients' serums that could not be controlled by heating. The incidence of natural antisheep amboceptor that gave a negative reaction in a positive serum was only 0.3 per cent of 2374 bleedings. We found the Kaliski-Bauer test to be inadequate as a diagnostic measure, but of value as a control. Absorption of natural antisheep amboceptor did not give us uniform reactions. As previously reported, we found the difference in fixative and hemolytic value of guinea-pig complements to be the greatest factor of variation in the gonococcus complement fixation test. In order to give a true interpretation of our diagnostic tests in relation to the clinical classification, we have had to include three reactions frequently encountered in our tests that were not mentioned by Citron. Otherwise, our interpretations agree with Citron's. Specificity tests with heterologous antigens gave no fixation with gonorrheal serums, as shown in table 3. Non-gonorrheal serums tested with gonococcus antigens gave no complement fixation. Tables 4 and 5 show the relative value of smear, culture and complement fixation. These three laboratory methods are discussed in a paper by Torrey and Wilson (15). The clinical value of our gonococcus complement fixation tests is discussed in the publications of Barringer and Williams (3), and Barringer and von Bose (2).