178 PROTEIN THERAPY 



Konteschweller in his review of "pyretotherapy" states that he has 

 obtained very satisfactory results in the treatment of gonorrheal 

 rheumatism. He used milk, kephyr and peptone to elicit the reactions. 

 Pakauscher uses "Fulmargin," an electrically prepared colloidal metal ; 

 this gives little general reaction but seems to be useful nevertheless 

 in the treatment of gonorrheal complications. Ullmann mentions the 

 successful use of milk in gonorrheal arthritis ; Fraser and Duncan have 

 recently reported on the treatment of a small series of such arthritic 

 cases treated with intravenous vaccine injections. The vaccines they 

 used had been stored for several months after their preparation, and 

 they were, therefore, probably more or less detoxicated. Whether a de- 

 toxicated vaccine has any specific properties or not requires proof. 

 They suspect that a vaccine minus its endotoxin consists simply of non- 

 specific proteoses in a colloidal form. The injection of these, possibly 

 nonspecific constituents, would seem to have caused the production 

 of specific antibodies. Clinically they seemed to get the same result 

 from injections of T.A.B. vaccine as from a gonococcus or mixed 

 vaccine. The chief reason for using a gonococcus vaccine was that 

 a supply was available, and its use afforded a great facility for 

 graduating dosage. Freshly prepared typhoid vaccine often causes so 

 severe a reaction that they would not risk giving it intravenously. 

 Injections of endotoxins always produce toxic symptoms with but lit- 

 tle or no increase of antibodies. Marked improvement followed in 

 all of the fifteen cases treated. No benefit seemed to result from an 

 injection that was not followed by pyrexia. At the time treatment 

 was commenced, the patients were extremely debilitated with a 

 rather fast and weak pulse, which was easily accelerated. The in- 

 jections were all intravenous. The size of the doses used compares 

 favorably with the doses recommended by Thomson for his detoxi- 

 cated vaccine. The largest dose of gonococci was 2,000 millions. 



The myositis of gonorrheal origin has been favorably influenced 

 by intravenous injections of "arthigon" by Sachs while Reichmann 

 has described a favorable influence of collargol injections in the treat- 

 ment of gonococcus endocarditis. 



Local Injections. The use of milk, recommended by Muller and 

 Weiss, has been quite extensive not only for intragluteal injection 

 and systemic reactions (Gellis and Winter) but for local injection in 

 or about the complication. Weiss has treated a number of cases 

 of epididymitis in this manner, injecting from 5tolOc.c. of milk sub- 

 cutaneously in the scrotal skin, and obtained excellent results. 



This treatment by local injections about the site of the lesion was 

 commenced by R. Muller who observed that if serum was so injected 

 it improved localized disease processes. Sandek then treated some 

 100 cases of gonorrheal complications with this method and obtained 

 excellent results. The analgesia following the injections was aston- 

 ishing. 



