GONORRHEA AND ITS COMPLICATIONS 183 



to be the main factor; the best results were noted in the patients 

 that presented the strongest reactions. 



Arweiler, working with Lindig on casein injections (intravenous), 

 reports satisfactory results in adnexal inflammations, the tumor masses 

 showing definite regression and the patients a general improvement in 

 condition. 



Schonfeld tried the method recommended by v. Szily and Stransky 

 (salt abscess) in 36 cases of acute and subacute gonorrheal infections 

 in women. They obtained very poor results; only those made a re- 

 covery in whom abscess formation occurred. The method is painful 

 and certainly not to be recommended. 



More recently a number of clinicians have tried the method of 

 turpentine injection with evidently more success. Fuchs, as well as 

 Schubert, while in military service, had tried intramuscular turpentine 

 injections in suppurating wounds without any effect (where we al- 

 ready have a large suppurating surface from which -necrotic products 

 are being absorbed, this result is to be anticipated), but found that 

 when used in adnexal inflammation he obtained quite remarkable re- 

 sults. Zoeppritz and Kleeman had previously reported a fairly large 

 series of cases and Fuchs reports 30 gynecological cases treated by the 

 injection of 0.5 c.c. (of 4 parts of turpentine, 0.2 part of eucupin and 

 16 parts of olive oil) every 4 days intramuscularly. The site of the 

 injection was the axillary line just below the crests of the ilium, in- 

 jection being made very deep. 



Kleemann's cases numbered over 60 and included all varieties of 

 adnexal inflammation. In this series 36 were completely cured, 21 

 improved and 3 were not improved. He observed that the fever as 

 a rule diminishes after a short time and the size of the adnexal tumor 

 decreased until in many instances it was no longer possible to palpate 

 the mass. He used turpentine with a small amount of novocain to 

 prevent local pain after the injection. 



The cases selected were bilateral adnexal inflammations, with the 

 tumor masses varying in size from 2 to 10 cm. in diameter, with oc- 

 casional temperature, menstrual disturbance pain, bleeding, etc. In 

 five of the cases a chronic gonorrhea was manifest. The results of the 

 treatment were very satisfactory, convalescence being established much 

 sooner than with the ordinary local or expectant treatment. Not only 

 was the local tumor mass reduced in size Fuchs states that the large 

 masses reduced in two weeks' time to the size of a walnut but the pa- 

 tients felt better in general and the appetite was stimulated. Occa- 

 sionally a temperature reaction of from 1 to 2 C. was observed fol- 

 lowing the injection; these cases gave the most striking clinical im- 

 provement. In no case did he have any untoward effect or find any 

 injury from the treatment; in over 200 injections there was no abscess 

 formation. 



According to Fuchs the treatment is of very definite gynecological 



