118 VACCINE AND SERUM THERAPY. 



injections, this suspension is heated to 65 C. for one-half hour 

 before the injection is made. Nine or ten injections are usually 

 necessary to produce serum of high value. After immunization 

 is completed, the animal is bled from the carotid arteries, and the 

 serum allowed to separate out. After this the serum is collected, 

 filtered and tested for sterility. Immunization is made in rams 

 because blood from these animals is apparently little toxic for the 

 human. Polyvalent serum is used because the immune bodies for 

 one strain are specific for that strain, and inasmuch as the strains 

 of gonococci vary in the different infections, immune bodies for 

 all strains must be present in the serum. 



Standardization of this serum has not been effectual. It 

 seems quite definite that this serum possesses no anti-toxic nor 

 opsonic value, but is dependent for its efficiency on its lytic action. 

 Because of a lack of any better method of determining the immun- 

 izing value of this serum, determinations have usually been made 

 of its agglutinating value. The amount of serum, injected is based 

 on cubic centimeters rather than units of immune substance. 



Torrey and Rogers' anti-gonococcic serum has been tried 

 in the treatment of the various gonorrheal infections. From time 

 to time favorable and unfavorable results have been reported. 

 The greatest value of the serum apparently is manifested in the 

 treatment of the complications of gonorrheal urethritis, such as 

 prostatitis, epididymitis, orchitis, cystitis, salpingitis, endocarditis, 

 pleuritis, meningitis and especially arthritis. The acute condi- 

 tions, urethritis, vaginitis, and conjunctivitis, are little effected 

 by this treatment. 



The method of treatment with anti-gonococcic serum consists 

 of injections of 2 c. c. of serum at intervals of from one to four 

 days, as may be indicated clinically. The injections of serum are 

 made in the loose subcutaneous tissue in convenient parts of the 

 body. In every case treated with anti-gonococcic serum all the 

 other methods known to be of value in the treatment of the par- 

 ticular condition should be employed. Anti-gonococcic serum seems 

 to cause serum disease more frequently than most of the other 

 immune sera. In all cases it is to be remembered that, because 

 this method of treatment frequently must be carried over a long 

 period of time, serum injections must be made at intervals of not 

 more than seven to eight days. 



