MICHIGAN ACADEMY OF SCIENCE. 157 



opsonogen representing about 10 millions gonococci from a culture that 

 had been kept on artificial media for nearly a year was performed. On the 

 second day following this treatment the swelling began rapidly to subside 

 and by afternoon the patient reported with the foreskin retracted, the glans 

 clean and free from redness or pus, and the urethral discharge much dimin- 

 ished. He stated that this was the first glimpse of the glans penis that he 

 had had for eight months. Four succeeding injections effected a further 

 diminution of the urethral discharge, which finally ceased entirely when a 

 few urethral injections were used to reinforce the inoculations, and at last 

 accounts the patient was well. 



A further -illustration of the rapid, specific action of the gonococcus op- 

 sonogen on the inflammatory complications of gonorrhea was seen in a case 

 of urethritis of six weeks' duration, complicated with a proctitis of three 

 weeks' standing, a double epididymitis for eight days, and a small periurethral 

 abscess in process of formation. I saw this young man in consultation 

 through the kindness of Dr. Andrew Sherman. Within 24 hours after the 

 first injection of the gonococcus opsonogen all pain on urination and all 

 backache had left, the swelling in the epedidymal tissues had subsided so 

 rapidly as to cause a "crawling sensation" from the retracting dartos, the 

 periurethral abscess had broken leaving a perineal urinary fistula. Follow- 

 ing these events the patient's appetite returned and became insistent and 

 he began a gain in flesh that continued imtil it had increased his weight 

 15 pounds, which was in excess of the previous normal. Several subsequent 

 injections at weekly intervals have been given. The proctitis quickly dis- 

 appeared and the urinary fistula so far closed that only a few drops of urine 

 were lost once out of several urinations, and presently the fistula healed 

 solidly with no local treatment directed to it. But the urethral discharge 

 completely subsided only when argyrol injections were used to fortify the 

 inoculations. 



At St. Mary's Hospital I treated by the same method a left-sided gonor- 

 rhceal epididymitis of a month's duration, as large as a hen's egg, much in- 

 durated and exceedingly tender. In 24 hours after inoculation the mass had 

 Ijegun to reduce in size, was softer, and much less tender. In 48 hours all 

 the swelling of the epididjanitis had subsided except an induration limited to 

 the head, and by the third day this had departed and the patient's general 

 condition was so excellent that he was discharged from the hospital. 



My constantly enlarging practice with chronic gonorrhceal discharges 

 constituting the so-called "gleet" and representing various lesions like 

 prostatitis, vesiculitis, anterior and posterior urethritis, and variously com- 

 plicated as with a low grade arithritis or only an arthralgia, goes to convince 

 me that proper bacterial therapy holds great promise for this class of dis- 

 orders which are so obstinate or intractable by other methods of treatment. 

 I have witnessed some most surprisingly satisfactory results in this class of 

 cases in which improvement in the local conditions, as shown by clearing of 

 a purulent mine, diminution or disappearance of gonorrhceal threads, abate- 

 ment of joint pains and the like, has been attended by disappearance of 

 the neurasthenia from which, as you all know,these patients suffer pecul- 

 iarly. Usually it has been possible to accomplish a satisfactory result with 

 the gonococcus opsonogen alone, but occasionally it has been necessary' to 

 employ an opsonogen from the secondary invading organisms like the staphy- 

 lococci, the pseudodiphtheria bacillus, bacillus mucosus capulatus, or the 

 colon bacillus, the necessity for which was determined by a prolonged study 

 of the predominating flora in the pus or in the threads. 



