114 SMITHSONIAN MISCELLANEOUS COLLECTIONS VOL. 63 



We have dwelt quite fully on this innovation in tuberculo-therapy 

 because it gives promise of good, practical results and, further, be- 

 cause it is so radically difit'erent from the prevailing methods adopted 

 in most sanatoria. But, the most interesting feature is the explana- 

 tion which is ofit'ered to account for the benefits which has accrued. 

 This explanation is set forth in an elaborate study made by A. C. 

 Inman, M. B., the superintendent of the laboratories of the Bromp- 

 ton Hospital, on the " Effect of Exercise on the Opsonic Index of 

 Patients Suffering from Pulmonary Tuberculosis."^ 



This study of Inman's was prompted and made possible by the 

 brilliant work of Sir Almroth Wright. Wright showed in his Har- 

 veian Lecture in New York, that there are three great agencies by 

 which immunizing responses can be evoked in the organism; 



(i) By the inoculation of bacterial vaccines. 



(2) By artificially induced auto-inoculations. 



(3) Ey spontaneous auto-inoculations. 



Wright had previously elucidated the subject of vaccine therapy 

 by constructing curves from the opsonic indices of patients vacci- 

 nated against their infection and in this manner traced a definite 

 train of events which follow upon a single inoculation. The succes- 

 sive phases were termed the negative phase, the positive phase and 

 the phase of maintained high level. Freeman, working in Wright's 

 laboratory, then took up the subject of massage in its efifect on gono- 

 coccal joints showing that "Auto-inoculations follow upon all active 

 and passive movements which affect a focus of infection and upon 

 all vascular changes which activate the lymph-stream in such a 

 focus." 



Wright's dictum was that " where in association with a bacterial 

 invasion of the organism bacteria or bacterial products pass into 

 the general lymph, and blood-stream, intoxication effects and im- 

 3iiunizing responses, similar to those which follow upon the inocula- 

 tion of bacterial vaccines, must inevitably supervene." It is a per- 

 fectly logical conclusion, then, that nature cures bacterial infections 

 through such auto-inoculations. Inman set himself to find out what 

 the body is doing of itself and what value extraneous circumstances, 

 such as physical exercise, have in aiding these attempts on the part 

 of the body. Inman's work was conducted on a carefully planned 

 technique, controlled and checked at all points, using forty-three 

 patients in the sanatorium treated by the System of Graduated Labor. 



Inman found that in 41 out of 43 cases the opsonic index w^as at 



' Read before the Medical Society of London, January 13, 1908. 



