REPORT OF THE DIRECTOR OF THE HOSPITAL TO THE

CORPORATION OF THE ROCKEFELLER INSTITUTE FOR

MEDICAL RESEARCH

Volume III    January 1912  - October 1914


Wbetanoe in the splitting of sugar which induoee this reaction.  The prob-

lems relating to intoxication are being attacked from several etandpotnte,

but the above indicates in general the line of procedure.

       Dr. Do&e8 ha8 continued his work in relation to the occurrence of

pneumooocci of the different types, Ymt Only in patient8 suffering from the

dioeaee, but slro in normal mouths.  While sufficient~etudiee have not yet
been m*de to bring oonulu~ire evids&e in regard to `this point, it seems

fairly evident that the pneumoaooci obtained from normal mouths are not of

Types I and II, but in general behave quite differently from these organir,

which are apparently more fixed in their ohansoterirtior.  The definite ao-

lutlon of this problem will be of some lmportanoe from the epidemlologloal

rtandpolnt.

     Dr. Avery@8 work at prerent is concerned with method8 for the con-

centration of the serum umed in treatment.  This work 80 far indiaate that

the PFOteotire 8ub8tmce8 are all contain& in the globes fraation, about

eqoallr distributed in the pseudoglobulin and the euglobulin. The reparation
of the so-called insoluble globulin by the method of paeeing CO2 ~8 thm@
the aem dilated in water hae given moat interesting results. This fraction
of the protein, which represent8 only about one-twentieth Of the total Protein
of the serum, oontains a large part d the protective eubatanOe@, 80 that it
is now por~ible to obtain a concentrated serum containing twenty times the Pro-

tective podPer of that of the whole serum, but containing no more protein than


the whole serum. Eo~ever , In the manipulation8 almost one-half of the pro tec-

tive subetanoer have been lost, and. a study Is now being carried on to try to
reduoe thie loss if possible.  Concentration with a loss of only twenty-five

percent we would consider very ratiefactory, and It is quite probable that thi8

result can be obtained by the preeent method after the technique baa been

better developed;  As soon as thle work Is completed, I hope to have Dr,


Avery study further the quetetlan of immunity to PIIellUIOCOCCUB

Syphilis.  During the past quarter Dr. Ellie has had to carry

on entirely alone the work of the treatmnt of patients snd, therefore,

hss been able to carry on very little study outside of the clinical study

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In the treatment of these patients.

The nethod of lntrarplnouo injection of aemrn, as devised by Dr.

Swift and Dr. Ellir, is now being employed quite widely throughout this

COUntfy with, in IDOUt aa#e#, favorable reault8.  Thlr wOrk has not only

been vsluable In itself, but it has undoubtedly etimulated a great deal

of work in the treatment of tab08 ani general psreri8 by intravenous trest-

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Tent alone.  The IVBBUltB of intensive intravenous tres tm8nt have undoubted-

ly shown that In many c88es exuellent rerultr may be obtained by this

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ma thod alone.  In other amei, however, It is necessary to use the intra-             i
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splnoue method before results are obtained.  In the future, no doubt, the     1;
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raethod will comlat In treatment, first by Intravenous injections, with

careful rttxiy of the spinal fhlid, an3 sec0nl, fn the caae8 whare eatlr-

factory results are not obtaIned, by the direct intraspinoue methOd of

trestrrent.  The lntrarpinoue method of troatment has been employed else-

where in the treatment of general p$re818, and a mxnber of Ob8erYOr8 haYe

reported. excellent results. All this work is undoubtedly going to ,lead to

very great lqrovdmentr in th8 method of treatment of tabes and general

pSl'e#i#.  Dr. Swift, who has Studied our case8 and ha6 investigated the re-.
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port8 of others, believe/ that taber can probably be arrested In ninety

per cent of the oases.

We believe that it is important' that in the future these uases be

treated as syphilis by those who, are engaged in the active treatment of this

disease, and not be treated by neurologists who have ilttls knowledge con-

cerning the nature of infectious disease and are little interested in apealflc