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Benjamin White has pointed out (2), protein free preparations of lipoid are totally devoid of the distinguishing characteristic of antigens, to wit, the property of stimulating antibody production. Nevertheless, the mixture of a suitable lipoid preparation and the serum of a syphilitic is capable of fixing large aitiounts of complement. The reac- tion is analogous to an antigen antibody comple- ment aflair. The determination of a positive or of a negative Wassermann reaction depends upon the fixation or nonfixation of complement. The presence in the test tube of free complement, after a suitable period of incubation, predicates nonfixa- tion, and is evidence of the absence of syphilis . antibody in the patient's serum. On the other hand, the absence of free complement, likewise after a suitable incubation period, indicates fixa- tion Cialis Sales Online Canada and evidences the presence of syphilis anti- body in the patient's serum. It is thus apparent that the essentials to a test for the presence or absence of syphilis antibody are the following: i, the proper dose of a suitable antigen; 2, a suitable quantity of the serum of the patient ; 3, complement which has been properly adjusted to the other elements of the hemolytic Cialis Sales Online Canada system; 4, suitable conditions of incubation. As I pointed out recently (3), a lipoid antigen which seems to meet the requirements of the test when suitable conditions of incubation are provided, namely 8° C. for four to twenty-four hours, is the simple alcoholic extract of beef heart. It is made as follows: Ten grams of chopped beef heart are extracted in 100 c. c. of absolute alcohol, at 37° C, for two months, in a tightly stoppered vessel. The mixture is shaken at frequent intervals during that time. Then the preparation is filtered through paper, the filtrate being essentially the warm alcohol soluble lipoids of the heart muscle. This filtrate is refrigerated over night. A powdery, gray precipitate forms, which is the hot alcohol soluble, cold alcohol insoluble fraction. This is re- moved by a second filtration. The second filtrate constitutes B. II. P., plain or simple alcoholic extract of beef heart. To Cialis Sales Online Canada determine the proper dose of the preparation, a series of titrations are performed. Cialis Sales Online Canada They are for hemolytic efi'ect, for antilytic or anticomplementary action ; and for antigenic property. For use in the titrations a ten per cent, emulsion of the alcoholic solution is made in 0.9 per cent, sodium chloride solution. It is a matter of some importance to make the emulsion by adding the salt solution to the alcoholic solution drop by drop, with constant agitation. Thus one takes one c. c. of the alcoholic solution and adds thereto, drop by drop, one c. c. of salt solution. By proceeding in this manner, a milky emulsion is produced. It is then diluted by adding eight c. c. of salt solution. If, on the con- trary, the nine Cialis Sales Online Canada c. c. of salt solution are added to the alcoholic solution all at once, without agitation, or if the alcoholic solution is added to the salt solu- tion, there results not a milky emulsion, but an Cialis Sales Online Canada opalescent, translucent solution. There is said to be a marked difference in the antigenic values of the Cialis Sales Online Canada two preparations, the emulsion being far more antigenic than is the solution. The former is in such a physical state as to present a larger absorb- ing surface. An antigen may in and of itself hemolyze red cells. It may, in and of itself, fix complement. It is therefore important to test out each preparation of antigen for its hemolytic effect and for its anti- lytic action. Increasing quantities of the emulsion are put in contact with constant quantities of red cells and the mixtures are incubated under suitable conditions. An opportunity is thus allowed for the hemolytic effect of an antigen, if it exists in the quantities used in Cialis Sales Online Canada the titration, to manifest itself. The titration for hemolytic effect is shown in Table I. Again, increasing quantities of the emul- sion are mixed with constant quantities of comple- ment and incubated suitably. An opportunity is thus afforded for the antigen, in the quantities used, to fix complement, if it will. Fixation or nonfixation is indicated in the usual manner. The titration for antilytic action is depicted in Table II. T.\BLE I. TITRATION OF LIPOID ANTIGEN : I. FOR HEMOLYTIC EFFECT. Antingen (1% emulsion)...... .1 .2 .3 .4 .3 Salt solution 7 .6 .5 .4 .3 R. b. c. (5% suspension) 2 .2 .2 .2 .2 Incubate at 40° C. for 30 minutes and read for hemolysis. There should be no hemolysis in any of the tubes. TABLE II. TITRATION OF LIPOID ANTIGEN : 2. FOR ANTILYTIC ACTION. Antigen (io% emulsionl I .2 .3 .4 .5 Salt solution 3 -2 .1 o o Complement two Cialis Sales Online Canada units in each tube Incubate for 4 hours at 8° C. Then add 2 units of ambo and I unit of r. b c. to each tube and immerse in water bath at 40° C. for 30 minutes. There should be Cialis Sales Online Canada complete hemolysis in all of the tubes. If there is any interference with hemolysis it is due to the antilytic action of the antigen. It is very exceptional to find a lipoid antigen pre- pared as outlined above which is hemolj'tic in the quantities tested. It is not unusual, however, to 490 SMITH: IVASSEKMASN TEST FOR SYFHIUS. (New Cialis Sales Online Canada Yokk Medical Jouhsai. find sucli an aiuif^'un somewhat antilytic in the