Signals In the Blood

The Wassermann test (1906) was a powerful weapon in the war against syphilis, but its many laboratory stages made it as slow and cumbersome as a medieval crossbow. What the medical warriors needed was a rifle. When Dr. (of Science) Reuben Leon Kahn took charge of Michigan's serology laboratory in Lansing 31 years ago, several starts had been made, but Kahn wanted to do better. On Thanksgiving eve of 1921, he recalls, "I walked home at a faster pace than usual. I wanted to tell my wife the exciting news: I had succeeded in bringing about spontaneous precipitation on mixing some strongly positive serums with a specially prepared antigen suspension."

In short, Scientist Kahn had developed the rifle. When he mixed the blood fluid from a syphilis patient with a substance prepared from fatty beef heart, the mixture quickly clouded and a deposit settled in the bottom of the test tube; with blood serum from a healthy individual, the clear fluid stayed clear. Thus was born the first simple and effective serum test for syphilis, and one of those in widest use today.* In popular lingo, Kahn tests are often called Wassermanns. Kahn, who took no cash for his discovery, lets the credit go too. Says he: "I don't care what people call it."

Run of the Mill. Like every other procedure designed for this purpose, the Kahn test had a flaw: it occasionally gave "false positive" reactions, indicating syphilis where there was none. Many researchers were content to dismiss these few false positives as run-of-the-mill defects. But not Kahn.

Lithuanian-born, American-educated Dr. Kahn has the type of mind which seems to work even when he is asleep. Often he will wake in the middle of the night, switch on a light and jot down a clue that has just occurred to him. The most promising clue that has occurred to Dr. Kahn's wakeful brain during 25 years of serum tests is that any human blood, healthy or diseased, will produce its own distinctive pattern of reactions when mixed with particular concentrations of beefheart extract. (Syphilitic serum happens to produce a strong reaction with a concentration chosen for the purpose.)

From this idea it is but a step to a bigger theory of health & sickness which Dr. Kahn (now at Ann Arbor on the faculty of the University of Michigan) has evolved. Some of the body's cells are constantly being destroyed, and in the process part of their lipid (fat-like) content passes into the blood. The system then automatically develops antibodies which react mysteriously with the dead-cell lipids. In the test tube, these antibodies react, in what Kahn holds to be a definite and ascertainable pattern, with the fatty stuff from beef heart.

Philosopher's Stone. Dr. Kahn believes that the system creates more antibodies when disease sets in, because disease kills more cells than usual. So, he argues, if the pattern of an individual's serologic (blood test) reaction is established while he is healthy, later tests will show whether disease is beginning to attack him. True, an explosive infection would make him ill before the blood test could show a rise in antibodies, but insidious, slow-working diseases such as tuberculosis might be detected by a blood test before they would otherwise be suspected.

If Dr. Kahn's theory of a universal blood reaction in sickness & in health can be proved in practice, he will have discovered something as eagerly sought as the philosopher's stone, and just as elusive. So far he has tested it on normal subjects and on victims of syphilis, yaws, malaria, tuberculosis and leprosy, and his elaborately charted findings have just been published as An Introduction to Universal Serologic Reaction in Health and Disease (Commonwealth Fund; $3.50).

Dr. Kahn is going on to tackle other diseases. He even hopes that an unusual blood-serum reaction might signal the approach of cancer before a detectable growth has formed. But Dr. Kahn admits that it may take 50 years for his work to be fully translated into cures. And cures, says he, are all that count.

* Several other precipitation tests also commonly used are based on the same principle. The true Wassermann, a "complement fixation" test, often serves as a court of appeal, is used to confirm positive reactions from other tests.

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