Refractometric studies with the sera of syphilitic patients under arsphenamin and neo-arsphenamin treatment

Refractometric studies were made by the writer upon thirty-two cases of untreated syphilis and the following observations were made:

1. There is a marked increase in the refractive index of the serum and also in the globulins in Syphilis, especially in active secondary cases. This confirms the findings of Rowe.

2. The refractive index of the serum is highest in secondary cases, lowest in the congenital and is intermediate between these two in the tertiary cases. The figures for total proteins, albumins, globulins and the relative amount of globulin are somewhat higher in secondary than in tertiary syphilis, the figures for congenital syphilis being somewhat lower than those of the latter.

3. Considered in relation to the Wassermann reaction of the sera, before treatment, the strongly positive cases show values of total proteins, albumins, globulins and relative amount of globulins higher, and values of non-proteins correspondingly lower than the weakly positive cases.

4. During a course of fourteen intravenous injections of arsphenamine (0.4 to 0.6 gm.) and neoarsphenamine (0.9 gm.), each drug being given at weekly and semi-weekly intervals, the refractometric studies (made before each injection) show the following results:

5. Classified according to the Wassermann reaction of the sera before treatment, there are no sufficiently constant or striking differences to warrant differentiating between the strongly and weakly positive series.

6. Considered according to the intervals of injection the data have much significance. The refractive indices of the sera, when neoarsphenamine was given at seven-day intervals, show a mcre uniform and continuous decline during the fourteen weeks of treatment, than when arsphenamine was similarly injected. The relative amounts of globulins, on the other hand, show more rapid decline during weekly arsphenamin than neoarsphenamin injections.

During semi-weekly periods of administration the changes are very irregular.