6i 4 SCIENCE PROGRESS 



typhoid, but not against staphylococcus ; and thirdly, there may 

 be many other anti-bacterial agents in the blood which we have 

 no means of demonstrating at all. It is therefore impracticable 

 to completely estimate all the anti-bacterial properties of the 

 blood, and we have to make a final consideration as to whether 

 a partial estimation is of value. 



The protective substances which are most readily estimated 

 are the opsonins. Their influence is exerted on nearly all 

 bacteria ; the technique is a comparatively simple one — no 

 delicate quantitative estimation of this kind can in any case 

 be carried out without considerable skill and great care — and 

 in skilled hands a very high degree of accuracy may be attained 

 in the estimation. 1 Its value, however, depends on the estab- 

 lishment of a general correlation between the clinical condition 

 and the condition of the index. It is submitted that the large 

 number of charts now published have established such a 

 correlation, and that a method which has brought to light 

 facts of the practical value of auto-inoculation, and by means 

 of which dosage has been so regulated that a pronounced 

 negative phase is hardly ever seen, is its own defence. One 

 more specific instance may be given. In Wright's laboratory 

 blood samples from two or more workers are used as controls, 

 and it is found that the counts of such blood are always in 

 agreement within narrow limits. On no less than three 

 occasions it has happened that persons, whose blood had at 

 first been normal, became abnormal, and in each of these 

 cases a tubercular lesion was afterwards clinically discovered. 2 



With regard to recent work, more and more organisms 

 have been exploited for vaccine treatment, and in the last few 

 years a most interesting use has been made of auto-inocula- 

 tion in the treatment of phthisis at Frimley, the convalescent 

 branch of Brompton Hospital. 



Paterson, following Walther of Nordrach, has employed 

 exercise in the treatment of phthisis. He has elaborated a 

 most careful graduation of labour, from a half-mile walk up 

 to full navvy work. He has used the temperature as a guide, 

 and on a rise to 99 work has been stopped and the patient 

 has been put to bed. It has been noted that after such a 

 rise there has sometimes been a marked improvement in the 



1 Fleming, Practitioner, May 1908. 



2 Wright and others, Lancet, Nov. 2, 1907. 



