THE SERUM TREATMENT OF GONOCOCCAL INFECTIONS 765 



THE SERUM TREATMENT OF GONOCOCCAL INFECTIONS 

 In 1906 Torrey and Rogers 1 described the preparation of an anti- 

 gonococcus serum and advocated its use in the treatment of gonococcal 

 infections, and especially of its various complications and metastases. 

 In the following year these observers reported 2 favorably upon the re- 

 sults of serum treatment in gonorrheal arthritis, and to a lesser extent in 

 infections of the genito-urinary organs. Uhle and Mackinney 3 used 

 the serum in the treatment of 23 cases of gonococcal infection, and found 

 it beneficial in three cases of gonorrheal arthritis and in one of myositis, 

 whereas in epididymitis and urethritis no appreciable effects were ob- 

 served. Herbst and Belfield, 4 Schmidt, 5 and Swinburne 6 agree as to the 

 value of the serum in gonorrheal arthritis, whereas in other complica- 

 tions they secured somewhat conflicting results. In all instances the 

 serum was used in relatively small doses, namely, 2 c.c., injected subcuta- 

 neously each day or every other day, the number of injections depend- 

 ing on the clinical condition of the patient. 



Recently Corbus 7 has reported more favorable results in the treat- 

 ment of 24 cases of gonococcus infection by using larger doses of serum 

 from 36 to 45 c.c. injected intramuscularly. This observer advocates 

 the use of the complement-fixation test as a reliable guide to the admin- 

 istration of the serum : the more intense the reaction, the more efficient 

 will the serum prove; if the reaction is negative, the serum should not 

 be used. 



Antigonococcus serum is advocated in the treatment of the following 

 conditions: 



1. In gonococcus bacteremia. 



2. In those infections arising by extension through the lymphatics 

 or the circulatory system, as, for example, arthritis, iritis, endocarditis, 

 and pleuritis. 



3. In those acute infections arising by direct extension from the 

 urethra, such as acute prostatitis and epididymitis; acute orchitis and 

 probably cystitis in the male; and acute salpingitis in the female. 



The serum has not proved of value in the treatment of gonorrheal 

 conjunctivitis, although it would appear advisable to employ it in large 

 doses administered intravenously or intramuscularly. 



1 Jour. Amer. Med. Assoc., 1906, xlvi, 261, 273. 



2 Jour. Amer. Med. Assoc., 1907, xlix, 918. 



3 Jour. Amer. Med. Assoc., 1908, li, 105. 4 Illinois Med. Jour., 1908, xiii, 689. 



5 Therap. Gaz., 1909, xxvi, 609. 6 Trans. Amer. Urol. Assoc., 1909, iii, 170. 



7 Jour. Amer. Med. Assoc., 1914, Ixii, 1462. 



