Complement fixation tests conducted with the cerebrospinal fluids of 130 persons suffering with acute anterior poliomyelitis and salt solution extracts of various tissues yielded from 6 to 16 per cent weakly positive reactions with extracts of spinal cord, pons and medulla, cerebellum, cerebrum and 15 to 17 per cent positive reactions with extracts of poliomyelitic liver and spleen. Control antigens of non-poliomyelitic human and rabbit liver yielded negative reactions, while extracts of spleen yielded from 5 to 7 per cent positive reactions.
With alcoholic extracts of these tissues the tests were uniformly negative.
The cerebrospinal fluids of normal persons and children suffering with whooping cough and measles yielded negative reactions with all extracts. The cerebrospinal fluids of several paretics yielded strongly positive reactions with all salt solution and alcoholic extracts.
Complement fixation tests with the sera of 58 persons in the various stages of acute anterior poliomyelitis yielded slightly positive reactions with 2 to 4 per cent of sera with salt solution extracts of spinal cord, pons and medulla, cerebellum and cerebrum. Tests with extracts of poliomyelitic liver and spleen were uniformly negative, as were all tests employing alcoholic extracts of these different tissues.
With polyvalent suspensions of diplococci and streptococci cultivated from persons suffering with acute anterior poliomyelitis, weakly positive reactions were observed with 6 to 9 per cent of cerebrospinal fluids of 35 persons suffering with the disease; with sera all tests were negative, as likewise all tests with fluids and sera employing suspensions of the diphtheroids and Gram-negative bacilli cultivated from poliomyelitis cases. These results indicate that the micrococci of poliomyelitis may produce antibodies during the course of the disease in a manner analogous to the production of antibodies by streptococci in scarlet fever.
The Wassermann reaction in acute anterior poliomyelitis is uniformly negative with both cerebrospinal fluid and blood serum.
These tests indicate that suitable salt solution extracts of various tissues from fatal cases of acute anterior poliomyelitis may serve in a very small percentage of cases to fix or absorb a small amount of complement in the presence of large amounts of cerebrospinal fluid, but the results in general are in accord with those reported by Wollstein, Gay and Lucas and the reactions are too irregular and weak to be of any practical value in the diagnosis of the disease.
Part of this paper was read in the symposium upon acute anterior poliomyelitis before the Philadelphia County Medical Society, November 6, 1916.