566 WHITMORE. 



still others have not improved. In epididymitis the symptoms are 

 usually relieved within twenty-four to thirty-six hours. 



I have had five cases of gonorrheal conjunctivitis, all the diagnoses 

 having been confirmed by finding the gonococcus in the discharge from 

 the eye. Two of these (both natives) did not come back after the first 

 injection, so nothing is known of the result. The other three cases cleared 

 up promptly after injection and none have.. any opacity of the cornea. 

 One of these cases was an infant, eleven days old. One man had gon- 

 orrhoea! conjunctivitis for two days. When the eyelids were separated the 

 pus welled out. Thirty-six hours after the first injection the discharge 

 from the eye was watery, and he made a prompt recovery with no opacity 

 of the cornea. Some days later his vision was still low, but there was no 

 apparent cause for it, I have been unable since to discover whether his 

 vision returned to normal or not. 



Gonorrhoea in women has not yielded satisfactorily to injections with 

 a stock gonococcus vaccine in my hands. In one series I treated 110 

 women between March 16, 1908, and July 17, 1908. These were cases 

 of urethritis, endometritis and bartholinitis and in all cases the presence 

 of the gonococcus was determined by microscopic examination of stained 

 smears: Of the 110 women, 31 came under treatment twice and 16 three 

 times. They received in all 623 injections of stock gonococcus vaccine. 

 There seemed to be some lessening of discharge in a few cases, but there 

 was no evident shortening of the length of time during which the gono- 

 coccus was found in the discharge, and recurrences seemed to be just as 

 frequent in the cases that received injections as in those that were not 

 injected. From my experience with chronic urethritis it seemed to me 

 that it would be necessary to make a personal vaccine in the cases of 

 endometritis, and recovery was prompt in four cases of long standing so 

 treated. One woman had been unable to do any work for two or three 

 months and had been in bed a large part of the time because of pain in 

 the pelvic region. There was considerable induration of the pelvic tissues 

 as felt through the vault of the vagina, and examination was very painful 

 to the patient. A vaccine made from the cultures taken from the cervical 

 discharge was injected in conjunction with a stock gonococcus vaccine. 

 After two injections the induration had disappeared and the woman 

 resumed her household duties, including the regular laundry work. 



Another series of cases of gonorrhoea in the female was treated by 

 making a personal vaccine for each case and injecting it in conjunction 

 with a gonococcus vaccine. When possible I prepared a personal gono- 

 coccus vaccine, but this was feasible in only a very small number of cases. 

 A vaccine was made from the other organisms grown from the cervix 

 in each case and this was combined with a gonococcus vaccine— personal 

 when possible, otherwise stock. 



Between December 1, 1908, and June 1, 1909, 156 patients were 



