ESTIMATION OF THE OPSONIC POWER OF THE BLOOD I57 



SO that I part of the emulsion was diluted with four of 0*25 per cent, 

 lysol. Lastly, it is pipetted off with a i c.c. pipette or hypodermic 

 needle (of course, sterile) into i c.c. ampoules, previously sterilized 

 by heat. 



The dosage varies with different bacteria and with different 

 cultures, and the following are approximate only. With staphy- 

 lococci it varies between 50,000,000 and 1,000,000,000, 500,000,000 

 being a good average. Meningococci may be given in the same 

 doses, or rather smaller : with a young child I commence with 

 25,000,000. B. coli is usually rather toxic, and may cause a good 

 deal of local and general reaction, and the first dose should not 

 exceed 20,000,000 ; it may subsequently be increased somewhat 

 if thought necessary. With pneumococci the dose may be 

 50,000,000 to 100,000,000 or more, and with gonococci 50,000,000 

 to 250,000,000. 



The dose of tuberculin (T. E. or T. R.) is -^-^j;-^ milligramme to 

 ainrTr milligramme. The material is bought in bottles containing 

 I to 5 cc, with the strength stated on the label, and dilutions 

 prepared with 0^25 per cent, normal saline solution, previously 

 sterilized. 



As regards the question as to the necessity of controlling the 

 injections by observations of the opsonic index, it is difficult to 

 speak with confidence. With staphylococci it is probably un- 

 necessary, and a small dose every week, or a larger one every 

 fortnight, will usually yield good results. In the case of tubercle 

 I am doubtful as to its advantage, but usually carry it out for one 

 or two injections in order to make sure that I am not dealing with 

 a patient with a very long negative phase, in which case I lower 

 the dose. In the other organisms I prefer, if possible, to take the 

 index regularly, and I believe this is especially desirable in the 

 case of meningococcic infections. 



The results of this method of treatment are extremely good 

 in the case of staphylococcic lesions (boils, acne, etc.), though 

 in some chronic cases a long course is necessary. In the 

 complications and sequelae of gonorrhoea (iritis, arthritis, etc.) 

 great benefit is also obtained, and some chronic pneumococcic 

 lesions (such as sinuses left after empyemata) heal very rapidly 

 after one or two injections. Chronic cystitis and pyelitis due to 

 B. coli axe, sometimes cured, but more often the symptoms are 

 greatly relieved without actual cure being obtained. Some cases 

 of ulcerative endocarditis and septicaemia have been completely 



