282 APPLIED IMMUNOLOGY 



Pneumococcus, Streptococcus pyogenes and Staphy- 

 lococcus should be mentioned. Bacterins compiled 

 from the first-named organism, whether isolated from 

 the joint, gmns, tonsils or feeces, have in a number 

 of instances rendered therapeutic service in the acute, 

 subacute and chronic forms of disease. We have never 

 observed any remarkable benefit by the employment 

 of the common pyogenic streptococci and staphylo- 

 cocci, nor is much to be expected in chronic cases 

 where hypertrophic osseous changes have occurred. 

 On the other hand, this is a field wherein gonococcus 

 bacterin enjoys much distinction. Indeed, biological 

 inoculations furnish the treatment pai' eoccellence for 

 gonorrhoeal synovitis and arthritis. Many patients, 

 with limitation of motion in subacute and chronic 

 gonorrhoeal joints, are best treated by preliminary 

 inoculations of Neisser bacterin a few weeks or months 

 prior to forcible manipulation under general anaes- 

 thesia, thereby eradicating the cause of the inflam- 

 matory exudate and preventing its re-formation after 

 operation. 



It should also be observed in this connection that 

 gonococcus bacterin is of exceptional value in the 

 differential diagnosis of many obscure joint and other 

 gonorrhoeal afflictions, used precisely as is tuberculin 

 in a diagnostic capacity. 



