SPECIFIC BACTERIAL REACTIONS 189 



inoculations of dead gonococci and suggested the use 

 of gonococcic bacterin in this capacity. At the time 

 of this report, one of the authors ( Thomas ) had been 

 utihzing an alternation of subcutaneous injections of 

 tuberculin, gonococcic, streptococcic, pneumococcic 

 and staphylococcic bacterins in the differential diag- 

 nosis of the etiological bacterium in obscure articular 

 affections, with a view to the determination of the 

 correct biological therapeutic agent. Contrary to 

 Irons' apparent greater reliance on the general and 

 focal reaction, Thomas attached more significance to 

 the local reaction at the injectional site, employing 

 much smaller doses, 100,000,000 instead of 500,000,- 

 000 cocci. Recently the substitution of unheated 

 bouillon filtrate or a filtrate similar to old tuberculin 

 for the bacterin has produced more dependable results. 

 Whether the filtrate or bacterin is used in small or 

 large dosage, subcutaneously or intradermically as has 

 been done by London, or by scarification, the reaction 

 to be looked for simulates precisely that observed in 

 tuberculin tests, namely, local hyperasmic areas with or 

 without papules or crusts, focal inflammatory changes 

 at the affected site, malaise, leucocytosis, rise in tem- 

 perature, etc. The reaction appears in six to twenty- 

 four hours and persists for two to three days, usually 

 unattended by systemic phenomena, unless large doses 

 are administered. No control is necessary, as relatively 



