226 APPLIED IMMUNOLOGY 



allel with the cHnical symptomatology, and although 

 in many cases it is unnecessary to employ the index 

 as a guide, there are many cases in which dependence 

 upon it is absolutely essential to attain the greatest 

 success. To ignore the index absolutely in all cases 

 will invite disaster. The authors feel, after an ex- 

 perience of many years, that the most brilliant results 

 — often in the most difficult cases — have attended 

 bacterin therapy, wherein the opsonic index was asso- 

 ciated in the management of the case; although they 

 are inclined to attach primary importance to the clini- 

 cal symptomatology, properly interpreted, and to 

 relegate the index to second place. For instance, in 

 the treatment of acne or recurrent furunculosis, we 

 are not infrequently at a loss, after the disappearance 

 of the present lesions, to say whether or not the process 

 of immunization has been carried far enough to insure 

 no recurrence, or in certain other affections, charac- 

 terized by a high fluctuating temperature and tox- 

 aemia, or in deep-seated lesions, such as pyelitis, pye- 

 lonephritis, cystitis, etc., the value of the index in 

 controlling dosage and, in the case of mixed infec- 

 tions, in selecting the needed bacterin, is not incon- 

 siderable. The treatment of this class of conditions 

 lies without the sphere of the general practitioner and 

 he would do well to refer such cases to those more 

 particularly versed in the application of bacterial in- 



