ARTHRITIS 143 



Twelve patients with subacute arthritis were treated; in 10 the 

 condition cleared up in from three to five days after from one to four 

 injections, although in 2 of them there was still slight stiffness or sore- 

 ness in one or more joints at the time the treatment was discontinued, 

 clearing up, however, a few days later. Two showed marked improve- 

 ment after two or three injections, but subsequent injections failed to 

 bring about further improvement. Among those discharged as cured 

 recurrences were recorded in 2, 1 of these recovering after further in- 

 jection; the other patient did not return to the hospital, for further 

 treatment. 



Nine cases of chronic arthritis with marked acute exacerbation were 

 treated and in 8 the acute symptoms cleared up promptly with from 

 one to three injections. 



Nineteen patients with arthritis of from a few months to several 

 years' duration were grouped as chronic arthritis. Only those cases 

 were selected in which there was definite evidence of activity, and 

 ankylosis was not marked. Ten of these patients after from one to 

 five injections showed a definite improvement, the acute tenderness 

 and discomfort on motion was much relieved. The patients became 

 less helpless. As a rule not all of the affected joints were bene- 

 fited. The results, however, were such that it would seem the treat- 

 ment had been actually beneficial. Not all of these cases have been 

 followed, but there are several in which, after the lapse of several 

 months, the improvement had been maintained. Five showed mod- 

 erate improvement, and 4 were not benefited. The maximum num- 

 ber of injections given any of these patients was thirteen, being 

 given daily in the beginning and later every two or three days. In 

 5 patients included in this group the arthritis was apparently of gon- 

 orrheal origin, and 3 of these showed such marked improvement 

 that they might be pronounced as cured. This is in contrast to the 

 resistance to the treatment of the acute gonorrheal cases. One of 

 these gonorrheal cases was of several months' duration and for 

 three months previous to entering the hospital the patient had been 

 compelled to use crutches. After three injections he was able to 

 get out of bed without assistance, and up to the present time (four 

 months) has not had a relapse. It is the very striking results ob- 

 tained in a few cases of this character which have led the authors 

 to believe that in certain instances the results obtained cannot be 

 equaled by any other of the present methods of treatment. The 

 results in the cases of chronic arthritis are on the whole, however, 

 not especially striking. The tendency to recurrence is great, per- 

 haps owing to the persistence of a focal infection. It is essential, 

 therefore, that where this method of treatment is employed, it be 

 preceded by the usual efforts first to locate and remove the local 

 infection. 



The reaction provoked by the intravenous injection of the typhoid 



