The Dreyer and Ward Sigma Reaction in Congenital Syphilis

Abstract

In a report to the Medical Research Council (l) of 1.342 It was noted that all cases of clinical congenital syphilis showed a definitely positive Sigma reading, i.e., greater than 1.5, and that the Wassermann reaction by the Harrison and Fleming methods was also positive. It was also seen that no case had a Sigma reading of 0 even after prolonged treatment, extending over five years in some cases. A few readings of a value under 2 were, however, recorded. The general tendency was for the Sigma to assume a lower figure in response to treatment.Of the 52 cases considered, 24 were suffering from eye affections. This proportion (46.1%) almost coincides with that noted by Jewesbury(2), ViZ., 42 out of a total of 84. It is possible that this high percentage is due to the desire for treatment for affections which cause more physical discomfort than many of the other manifestations of the disease. Of these 24 cases, 20 showed a Sigma reading over 10, 17 were over 30, and 5 were over 200, when first presented for treatment.There were four cases of iritis with the Sigma ranging from 59 to 94. One of these was under treatment for 26 months and by then had a reading of 1.8. In another, as a result of the first month's treatment, the Sigma fell from 94 to 33. This feature of a marked preliminary fall was noted in many cases in the series, and was usually followed by a much more gradual decline in the succeeding months. The accompanying illustration represents this