The FTA ABS test is almost as specific as the TPI test and may be even more sensitive, especially in early syphilis. Nevertheless it appears that some blood specimens which are reagin-positive and FTA ABS negative still prove to be positive by the TPI test, so that they cannot be called BFP's; and oddly enough, the Reiter test is also still found useful in some of these cases.

But granting that a margin of error can never be entirely eliminated from such biological tests and allowing for the time it takes to do a battery of them, the expense, and the agony that is sure to be felt by the person being tested, it still remains true that we have adequate means for the diagnosis of syphilis. With the recent increase of congenital syphilis several new problems have arisen. Clinical signs in the infant may be absent or inconclusive. The mother's history may call for blood testing the baby, but the results of such tests, whether positive or negative, may be ambiguous, first because the baby may not yet have begun to produce typical antibodies in sufficient amount for a positive test, and second because antibody that is found may have come from the mother through the placenta rather than from the infant himself. But antibodies can now be distinguished by special methods, and those capable of passing through the placenta can be separated from those that are not. FTA ABS tests based on such separation and pointing therefore to antibodies produced by the baby himself have been developed. There has also been a suggestion that X rays of the infant can help identify congenital syphilis by showing typical bone deformities.

Further improvements are in the works, including automated methods which for an RPR card test can process a hundred samples per hour; automation is also being applied to treponemal antibody tests and may be one way of simplifying them. But the fact is that errors are few. The current reports on automation and other refinements seem to me to go a little further than the circumstances may warrant. There is a suggestion in the reports, between the lines, that the problem of syphilis, like war and the poor, will always be with us. It looks as though we are becoming resigned to failure to control the disease. If we can control it, the refinements are unnecessary; if we can't, they are unimportant.