In view of the fact that a majority of the cases reported are patients who have suffered from arthritis for years, with either only temporary relief or no palliation whatever from general forms of treatment such as physiotherapy, diet, purgatives, splints, removal of foci, etc., we feel the tables demonstrate that vaccine has a real value in the treatment of chronic non-specific arthritis of every clinical form.
If patients' complements were titrated to determine vaccine tolerance, and if the dosage were decreased instead of increased every time there is any indication of an unfavorable reaction, vaccine would stand in much higher favor than at present.
We believe that the vaccine must be as nearly specific as possible, and we use individual ones made up of all the evident autogenous focal strains plus whatever complement-fixing strains are found positive in the patient under treatment. We do not believe one single strain of streptococcus or of any other organism is causative of arthritis, but feel that streptococci of several types, mostly of the infrequens and faecalis groups, are the major offenders in the production of this disease.
We have no criticism of agglutination or skin tests in determining the type of infection, but feel that both these methods fail to give a titration of the patient's complement and we consider the complement fixation reactions more convenient and specific.
All possible methods must be used to build up the patient. Arthritis is a systemic disease and must be treated as such. If every tolerant case of active arthritis were treated with a proper vaccine properly administered at onset of symptoms, there would be much less disability and suffering from this most widespread disease. Arthritis is not the hopeless disease so many of the profession have pictured it to be. On the contrary, it can be controlled and relieved more completely than most chronic diseases.
(C) 1931 All Rights Reserved.The Journal of Bone and Joint Surgery, Inc.