68 PROTEIN THERAPY 



unless perhaps an increase in the opsonins. The agglutinins and 

 bactericidal substances were not increased. 



Liidke found the complement somewhat decreased but found that 

 there was no consistent increase in antibodies, v. Groer as well as 

 Svestka and Marek observed no increase in agglutinins after the 

 injection of "typhin" in typhoid patients. Dollken, using milk, noted 

 that the injections did not alter the titer of dysentery agglutinins in 

 patients ill from dysentery. When he used a specific vaccine he did 

 observe an increase of these antibodies, but clinically there was no 

 difference in the effect on the disease whether milk or specific vaccine 

 was used. Reibmayr also found no changes in the agglutinins follow- 

 ing the injection of typhoid vaccines. 



Flechseder, on the other hand, observed an increase in agglutinins 

 after albumose injections in typhoid patients, while Parlavecchio found 

 an increase in agglutinins and in complement after the injection of 

 nucleins. Borchardt determined that organ extracts (adrenalin, 

 spermin, thyroid, etc.) increased the agglutinin titer of experimental 

 animals, in one case from a titer of 1:20 to 1:5120 and in another 

 case from 1:1280 to 1:12,240. 



Culver's investigations are perhaps the most extensive in this 

 field. The opsonins and bactericidal substances were studied in the 

 serum of sixteen patients suffering from gonorrheal arthritis. An 

 injection of killed gonococci or proteose solution was given intra- 

 venously every seventy-two to ninety-six hours until three to five in- 

 jections had been given. The serum was taken for study just before 

 each injection. Ten of these patients received successive injections of 

 proteose and six received killed gonococci. No marked difference was 

 seen in the results of the two groups. 



His conclusions are as follows: "Primary and secondary proteose 

 preparations stimulate antibody production or mobilization for spe- 

 cific organisms in gonococcal arthritis, in a manner not to be dis- 

 tinguished from that produced by the injection of the specific organisms 

 themselves. 



"In gonococcal arthritis, there is either no change or a decrease 

 in the antibody content of serum within the first twenty-four hours 

 following an intravenous injection, in all excepting the first injection 

 when the lytic substances seem to be slightly increased during this 

 time. 



"In favorable cases the first injection usually causes the greatest 

 clinical benefit. However, refractory patients may give a similar 

 lysin increase during the first twenty-four hours following an injec- 

 tion; hence the subjective and objective improvement in favorable 

 cases cannot be unquestionably attributed to an increase in anti- 

 bodies alone. However, little as these substances may have to do 

 with the early relief of symptoms in gonococcal arthritis, it may be 



