SIGNIFICANCE OF PHENOMENON 373 



May 7th gave consistent neutralization with 50 units. Later 

 bleedings revealed no increase in neutralizing potency. 



In addition to the studies on M. K., sernni from 8 patients was 

 tested tor capacity to neutralize gonococcns reacting factors. Tavo 

 of these patients were convalescing from gonococcic bacteremia, 

 2 Avere suffering from chronic gonococcic inethritis ^vith arthritis; 

 4 serxed as controls (no history or evidence of gonococcic infec- 

 tion) . The serum of the convalescents from gonococcic bacter- 

 emia gave consistent neutralization xvith 15 and 37.5 iniits, re- 

 spectively. The results of these investigations are smnmarized in 

 Table xi \vhich demonstrate clearly that the sennn of the con- 

 \alescents from gonococcns f)acteremia possessed much greater 

 neutralizing potency than the serum of patients with no history 

 or evidence of gonococcic infection (5 to 8) and 2 patients with 

 chronic nrethritis with arthritis without e\idence of bacteremia. 



It is of considerable interest that despite frequent tests no 

 evidence of complement-fixing, agglutinating and precipitating 

 antil)odies conld be demonstrated in any of the samples of sernm 

 M. K. The sole serological evidence of an immune response lay 

 in the development of the capacity to neutralize gonococcns react- 

 ing factors. Torrey (1906-07) , W^atabiki (1910) , and Negre 

 (1913) pointed out that there may be a lack of correlation among 

 the complement-fixing, agglutinating and precipitating antibodies 

 in antigonococcic sernm. 



The development of neutralizing antibodies in patients suffer- 

 ing from gonococcic infections w^ith a rise in the titer of the 

 neutralizing antibodies dining clinical improvement is most sug- 

 gestive of a causal relationship betxveen the two processes, namely, 

 the acquisition of an active immunity to the active principles of 

 the phenomenon and the recovery from the infection. Serum 

 w4th high neutralizing potency thus far has loeen noted only in 

 cases Avith systemic infection. Here one must draw attention to 

 the fact that local gonococcic infections seem to produce little 

 active immunity inasmuch as patients Avith chronic gonorrheal 

 urethritis may become reinfected readily after exposme (Jadas- 

 sohn) . 



It has been pointed out by Bruckner and Cristeanu (1906) , 

 Vannod (1906), Wollstein (1907), Torrey (1906-07), Dopter 

 and Koch (1908) , Watabiki (1910) , Tulloch (1922) , and Boor 

 and Miller (1931) that the gonococcns and meningococcus have a 

 close biologic relationship. HoAvever, they can be differentiated 



