176 PROTEIN THERAPY 



chill, followed by a temperature of 105 F. Malarial parasites were 

 found in the blood, but the chills and fever were allowed to con- 

 tinue for 4 days, at the end of which time all evidence of local in- 

 fection had disappeared. He remained in the hospital for 2 weeks, 

 without recurrence of the infection, having had no local treatment 

 whatever. The influence of fever on these infections in the medical 

 wards is of course well known; one rarely, if ever, sees a gonorrheal 

 infection coexisting with some fever-producing disease like pneu- 

 monia, typhoid, or malaria while gonorrheal infections are relatively 

 common among the chronic nonfebrile conditions. 



The therapeutic results in the group which forms the basis of this 

 report very noticeably correspond to the temperature increase and 

 to hyperleukocytosis. Considering the fact that the gonococcus is 

 heat sensitive both in vitro and in vivo; that fever patients cannot 

 be experimentally infected with the gonococcus; that a fever-produc- 

 ing disease spontaneously cures previously existing gonorrheal in- 

 fections, there can be but little question that fever artificially pro- 

 duced plays some part in the recovery from these infections. 



How much influence, if any, the leukocyte increase in the peripheral 

 circulation has, cannot easily be determined, for when artificially 

 produced in the manner employed here, the fever and hyperleukocytosis 

 are invariably present together. 



It is apparent that the usual treatment of gonorrheal arthritis is 

 not satisfactory in all instances, when almost daily one can see an 

 ankylosed joint and atrophied muscles following this condition. Should 

 this treatment by intravenous protein injections prove to give perma- 

 nent results in this condition, as present data seem to indicate, are 

 we justified in using such a measure? In view of the chronicity of the 

 disease and the destructive complications that commonly arise it 

 would appear to be a rational procedure when properly used and 

 controlled. However, until some substance is obtained whose dosage 

 can be more definitely standardized, it would seem that this form of 

 treatment should not be generally used by those not thoroughly fa- 

 miliar with the reaction and the manner of regulating the size and 

 interval of dosage of such, as used in the work here reported. 



In a recent review of his work Culver states that in his experi- 

 ence at one of the military camps during the war where intravenous 

 injections of gonococcus protein was made in every case of epi- 

 didymitis, the results were most satisfactory, the average stay in the 

 hospital being from 5 to 6 days. Even the primary localization of 

 the organism in the urethra or extensions of the infection into the 

 prostate and seminal vesicle responded more readily to local treatment 

 after nonspecific injections of this kind than cases not injected. 



Since the publication of these papers by Culver a considerable 

 literature on the subject has been accumulating, all of which reveals 

 practically the same general clinical experience namely, that non- 



