150 - NINTH REPORT. 



germ is capable of effecting recovery from the subacute or chronic infection 

 induced by it. To these bacterial preparations Avhich consist essentially 

 of the suspended bodies of the microorganisms, heated just sufficiently to 

 insure their death, and preserved with a chemical germicide like lysol, Wright 

 has given the name "vaccine," which seems to me an unfortunate term; 

 and in its stead I have proposed the adoption of the Avord "opsonogen" — that 

 which forms or generates opsonin. Let us then understand that the opsono- 

 gen of opsonic therapy is a small dose of an ascertained number of dead bac- 

 teria; the microbe being a "corresponding" one, that is, identical in species 

 with the one ]iroducing the infectious condition under treatment; or better 

 still, the "autogenous" one, as I have chosen to eall it, obtained directly 

 from the patient's lesion, and reintroduced for curative purposes. 



Daily tests of the opsonic index following the injection of a bacterial 

 opsonogen show that at first there is a falling in opsonic power of the blood 

 serum, this being named the "negative phase" by Wright; which is succeeded, 

 after an interval of hours or several clays, with an increased opsonic index 

 constituting the "positive phase." A practical rule of apparently prime 

 importance is not to reinoculate during the negative phase, and preferably 

 only when the index is again tending downward after the positive phase. 

 Clinically one can recognize these fluctuations in opsonic power by the con- 

 stitutional depression in the negative phase, often with an aggravation of 

 the lesion, and the increased tone of the positive phase with betterment of 

 the local condition. By repeating the proper dose of bacterial opsonogen at 

 the right intervals (averaging 7 to 10 days) a successful result witnesses a 

 progressive rise of the opsonic index to a maximum and sustained point, 

 and with this a restoration of the patient. 



The list of diseases amenable to artificial curative immunity as produced 

 by bacterial inoculation is a long one. It includes such staphylococcic skin 

 affections as acne, furunculosis, sycosis, and in my own experience I have 

 been able to add seborrhoeic dermatitis and eczema; pneumococcic infec- 

 tions like empyema, cystitis, suppuration of the antrum ; colon bacillus infec- 

 tions such as cystitis, pyelitis, pyelo-nephritis, and unhealed post-operative 

 fistulas; gonococcic infections like acute, subacute and chronic gonorrhoea, 

 gonorrheal rheumatism, gonorrheal epididymitis, ophthalmia and conjunc- 

 tivitis; tuberculous diseases such as lupus, arthritis, cystitis and nephritis, 

 e])ididymitis, adenitis, laryngitis, iritis, and some cases of pulmonary tuber- 

 culosis. Lately the method has been successfully applied in vegetative 

 endocarditis, and in some cases of typhoid fever. It requires no great stretch 

 of imagination to conjure a much more extended list of morbid medical and 

 surgical affections which are embraced in the prospective field of opsonic 

 therapy, and if present promises hold good it is not too much to predict that 

 Wright's discoveries have opened a new territory of therapeutic conquest 

 for microbic diseases more extensive in its scope than that of any single ad- 

 vance in the science of and art of medicine. 



PERSONAL CLINICAL EXPERIENCE. 



As to what may be accomplished in apph'ing the practice of bacterial 

 therapy as based on the theory of opsonins, I can perhaps best illustrate 

 by briefly reviewing some cases that I have personally treated since last 

 midsummer and which will serve as types of the various groups. This re- 

 view must necessarily be condensed and only the sailent features of the 

 various cases can be touched upon. And further, since I have already re- 



