342 IMMUNOLOGICAL METHODS OF DIAGNOSIS 



focal reactions have been observed by various investigators, and 

 it would appear from the published reports that a considerable 

 degree of diagnostic importance may be attached to such focal 

 reactions, while local reactions at the point of injection are apt 

 to be misleading. Reiter expresses himself quite enthusiastically 

 regarding the method in gynecological cases. Fromme, on the other 

 hand, obtained only 36.6 per cent, of positive focal reactions in 

 gonorrhea! tumors of the adnexa, as contrasted with 83.3 per cent, 

 of local reactions. Von de Velde, Kutner, and Schwenk have noted 

 an increased discharge from the uterus and urethra following vac- 

 cination, and state that in the resulting exudate gonococci could 

 be demonstrated which previously had not been possible. Very 

 important further is the observation that a "provocative" injec- 

 tion in cases of gonorrhea! arthritis is followed by a temporary 

 increase in the amount of pain (negative phase), and this in turn, by 

 manifest subjective and objective improvement (positive phase), 

 whereas in non-gonorrheal cases there is no change whatever. 



Considering the encouraging results which may be reached in the 

 diagnosis of latent gonococcus infections by the complement-fixation 

 method, and the data just given it would seem that in the future 

 doubtful cases of gonococcus infection should rarely give rise to any 

 special difficulties in diagnosis, and that in cases where marriage is 

 contemplated a definite answer can be given as to whether or not 

 any endangering residual infection still exists. 



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Widal, F., and Sicard, A. Etude sur la diagnostique et sur la reaction agglutin- 

 ante chez les typhiques, Annal. de 1'Inst. Pasteur, 1897, xi, 376. 



Winterberg, H. Untersuchungen ii. d. Typhusagglutinine und d. aggluti- 

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