MICROCOCCUS CATARRHALIS 385 



Specific injury to the nervous system by injections of gonococcus 

 toxin has been reported by Moltschanoff. 1 



The secretion of a true soluble toxin by the gonococcus, asserted by 

 Christmas, 2 is denied by Wassermann, 3 Nikolaysen, 4 and others. Christ- 

 mas, 5 and, more recently, Torrey, 6 have reported successful active im- 

 munization of animals by repeated injections of whole bacteria. Torrey 

 and others apparently have successfully treated human cases by injec- 

 tions of the serum of immunized animals. 



Antibodies to Gonococcus. Patients infected with gonococci 

 seem to produce antibodies against the organisms. Although in the or- 

 dinary gonorrheal urethritis, or vaginitis, it is relatively simple to make 

 . the diagnosis by finding gonococci in the discharges, diagnosis may be 

 difficult in cases of gonorrheal rheumatism, or endocarditis, when iso- 

 lation of the bacteria fails or when the connection between the local 

 venereal disease and the general condition is obscure. Various sero- 

 logical diagnostic methods have been attempted, and of recent years 

 the complement-fixation test has been found to be very useful. The 

 method has been especially developed by Archibald McNeil, at the 

 New York Department of Health. It consists in making a polyvalent 

 antigen, using the 10 Torrey strains which are kept in stock transplants 

 on glucose afecitic agar. It has been found that the best medium for 

 antigen production is an agar made of "bob veal." For the production 

 of antigen, stock cultures are transplanted on "bob veal" agar, without 

 salt, glucose or ascitic fluid, the reaction carefully adjusted to an acidity 

 of 0.1 per cent to 0.2 per cent. Twenty-four hour growths on this me- 

 dium are scraped off and emulsified in neutral sterile distilled water." 

 The emulsion is autolyzed one hour in a water bath at 56 and heated 

 one hour at 80 C. It is then filtered through a sterile Berkfeld filter. 

 The filtrate is aseptically bottled and sterilized 3 days at 56, half an 

 hour each day. It is then made isotonic and is ready for titration. 



Vaccine therapy in systemic gonorrheal infection has been tried and is 

 reasonably successful. The vaccine, if possible, should be made with 

 the organism isolated from the patient, for reasons described above. 

 Passive immunization with the serum of gonococcus-immune animals 

 has also been attempted, but records on it at present are not sufficiently 

 complete to permit definite judgment. 



1 Moltschanoff, Mtinch. med. Woch., 1899. 2 Christmas, Ann. de 1'Inst. Pasteur, 1897. 

 3 Wassermann, Zeit. f. Hyg., xxvii, 1897. 4 Nikolaysen, Fort. d. Med., xxi, 1897. 

 & Christmas, loc. cit. 

 6 Torrey, Jour. Amer. Med. Assn., xlvi, 1906. 



