CASE REPORTS 165 



all over the body, and particularly on the legs. Insufferable 

 itching. Sleepless nights, emaciation. General condition 

 bad, attributed . to insomnia. Transient gastro-intestinal 

 disturbances. 



The patient has consulted several specialists, and has tried 

 several external treatments and changes in diet, without 

 lasting success. 



Examination of the Intestinal Flora. No account was 

 taken except of germs which grew in twenty-four hours' 

 incubation on ordinary gelatin slants (meat-broth, pep- 

 tone). 



Found. Colon bacilli 90 per cent., enterococci 5 per cent., 

 indeterminate diplococci 3 to 4 per cent., very small strepto- 

 cocci 1 to 2 per cent. 



Preparation to be Injected. Ml the germs were mixed in 

 0.7 per cent, salt solution in the proportions in which they 

 grew on the gelatin. The mixture was distributed in sealed 

 ampoules, sterilized by heating to 70 C. for an hour. 



Each ampoule contained about 1 c.c. of liquid with about 

 0.02 mg. of bacterial matter dried at 140 to constant 

 weight. 



Treatment. First Series of Injections. First injection at 

 2 P.M., 1 c.c. into the muscular tissue of the arm. Slight chills 

 three or four hours after the injection. No itching at night, 

 good sleep. Next day, slight general fatigue, slight pain and 

 redness at the point of inoculation. 



Second injection, twenty-four hours after the first, 0.5 c.c. 

 followed every day for a week by injections, increasing the 

 doses from 0.1 c.c. to the maximum of 1.0 c.c. 



The patient no longer suffers from itching, the plaques 

 have faded and are not so moist. 



No treatment for the next month. 



At the end of the month, the plaques are clearly on the 

 road to recovery. There is no more itching, sleep is good, 

 general condition much improved. 



New Examination of the Intestinal Flora. The same germs 

 are found in the same proportions. 



Serum Diagnosis. The serum of the patient does not 

 agglutinate any of the germs in a 1 to 40 dilution. 



