158 NINTPI REPORT. 



In the gonorrhceal affections of loomen my work is still too small to justify 

 more than the prediction that here, also, bacterial therapy promises a great 

 boon. And in those unfortunate examples of accidental vaginitis in infants, 

 and in ophthalmia neonatorim I have already had sufficiently personal ex- 

 perience to say that opsonic therapy will prove a most important adjunct 

 to other well established methods. 



It will not be unwelcome news to you to learn that gonorrha^al 'polyarth- 

 ritis or gonorrheal rheumatism, can be conquered by the use of the specific 

 opsonogen. In one of my first patients, from Dr. George Slierman's prac- 

 tice, the infection had existed four months and involved several joints. 

 Progressive betterment of the arthritis with the departure of the swelling, 

 pain and immobility was effected by four injections' when the patient con- 

 sidered himself cured and no longer reported. In another instance a man 

 who was sent to me by Dr. F. J. W. McGuire, was almost a helpless cripple 

 with a gonorrhceal arthritis of four years' duration involving both wrists, 

 both shoulders, one elbow, and one knee, all the affected joints being im- 

 movable or of very restricted mobility. The usual symptoms of pain, 

 sleeplessness, cold sensation, cold sweats and physical and mental depres- 

 sion were in evidence. Seven injections at weekly intervals have worked 

 a most surprising improvement in this man's condition. Practically all 

 swelling and thickening of the joints have subsided, and all are now freely 

 movable, the range being normal except for the left wrist. Along with the 

 gratifying local improvement there has been a practical cessatin of joint 

 pain, good restful sleep undisturbed by chilly sensations or sweats, a pro- 

 gressive improvement in appetite and a steady gain in weight, and with this 

 a revival of spirits and a physical activity very pleasant to witness. 



CONCLUSION. 



In dismissing this necessarily hurried account of my clinical experiences 

 in bacterial therapy I would remind you that only illustrative cases have 

 been chosen and that these represent the general trend. My failures thus 

 far have been confined to two cases of advanced pulmonary tuberculosis where 

 the outlook was known to be unpromising and where no improvement fol- 

 lowed a cautious use of tubercle opsonogen. I also made a single inocula- 

 tion of a streptococcus from a badly infected foot and leg in a patient of 

 Dr. Theo. McGraw's, where didYSinced /parenchymatous nephritis and uremia 

 existed. Getting none of the usual favorable results further inoculations 

 were not attempted. 



Not all cases inoculated with the proper bacterial opsonogen do equally 

 well; some respond rapidly, others are more stubborn. A single inoculation 

 may suffice to establish a sustained high tide of immunity, while again the 

 treatment must be long and continued to reach this end. Indeed, as I have 

 recently insisted, each case of opsonic therapy is a law unto itself, and this 

 consideration applies not alone to the prospective outcome, but also to the 

 task involved in determining the identity of the offending organism and to 

 the judgment required in the use of that organism. And this brings me to 

 speak a few words suggested by the many inquiries wdiich have come to me 

 from physicians in all parts of the United States since the first report of my 

 clinical experience with Wright's therapeutic methods. An account of the 

 remarkable success which attends the proper application of bacterial therapy 

 is naturally most stimulating to every medical man who seeks to give his 

 patients the benefit of all the resources of hi^ art, and it is important that 



