GONORRHEA AND ITS COMPLICATIONS 175 



so one should exercise care and judgment in the selection of cases. 



Renal Involvement. From the proper dosage in this series, there 

 were noted no other symptoms attributable to the injections. Special at- 

 tention was given the kidney function, particularly in three patients 

 who had received large doses of colon bacilli. In no instance did al- 

 bumin appear in the urine, nor did any indication of kidney involve- 

 ment arise. One patient having a chronic diffuse nephritis with con- 

 siderable albumin in the urine had two injections with no appreciable 

 change in the kidney function. 



This seems to be significant, as Breed and others had found that 

 there is quite a marked increase in nitrogen output after such a re- 

 action, this increase being maximum on the sixth day. She advises a 

 low protein diet for a few days before such injections to prevent a 

 possible kidney change. 



Foekler reported epileptiform seizures after similar intravenous in- 

 jections, and Fischer in one instance noted cerebral symptoms, which 

 passed off in 24 hours. 



Delirium was noted in three patients of this series, all of which had 

 received large doses of colon bacilli. 



Culver was particularly impressed with the possibility that the 

 febrile reaction itself, the mere increase in the body temperature might 

 be involved in the therapeutic effectiveness of the nonspecific therapy. 

 A number of observers who at former times considered this factor in 

 resistance to infection and recovery from disease, among them Wal- 

 ther, Hildebrand, Englehardt, Roily and Meltzer, have reached the 

 conclusion that high temperature artificially produced has a favorable 

 influence on any established infection; on the other hand, cold seems 

 to retard the formation of immune bodies. The optimum temperature 

 for the growth of the gonococcus in vitro is 97 -98 F. Any appreci- 

 able increase in temperature has a very deleterious effect on the life 

 and growth of the organism. A sudden rise to 102 F., or over, means 

 certain death of the culture. 



When acute epididymitis develops, does the fever produced thereby 

 have anything to do with the spontaneous cure of gonorrhea? Many 

 patients with infections terminating thus have had considerable fever 

 during the onset of the complication. On the other hand, patients are 

 seen with infections terminating in a similar manner having had a 

 normal temperature throughout; this, however, does not seem to be 

 a common occurrence. 



Experimental urethritis in man has been produced, but Finger, 

 Gohn, and Schlagenhaufer regularly failed when the experimental 

 patient had a temperature of 102.2-104 F. due to some preexisting 

 disease. 



Culver calls attention to a patient who entered the hospital with 

 acute urethritis of 3 days' duration. A positive gonococcus culture 

 was obtained on entrance. The second day in the hospital he had a 



