The short paragraphs, headed "Comments ", have been added,
following the description of each group of cases, in order to
avoid making this section of the Thesis too cumbersome to read,
but I would like to stress certain points:-
(1) By administering Sulphanilamide in small daily doses
(2 gm and'under) the tendency to relapse, and to subsequent
resistance to therapy, is definitely increased.
(2) Relapses were most commonly occurred in the nervous,
introspective type of patient, and since withholding
Sulphanilamide from this type in such cases, and not giving
small doses, I have not encountered any further relapses.
(3) Patients who do not respond to Sulphanilamide therapy
within 10 days need not be expected to do so at all.
(4) Complications of the disease, especially prostatitis, do not
respond favourably to Sulphanilamide treatment.
(5) Routine urethroscopy, and repeated prostatic smear tests
should be carried out in all cases preparatory to
discharging them, in view of the possibility of "Latent
Littritis ", and "Prostatitis ".
(6) It should be very strongly impressed upon each patient,
the necessity for regular and continued attendance until
they are discharged. This is of special importance in
view of the early favourable reaction to Sulphanilamide
treatment which occurs in the great majority of cases.
(7) Large doses of Sulphanilamide are not necessary, or advisable, particularly in patients who are debilitated.
(8) In my experience a dose of 4 gm daily of Sulphanilamide
has provided the best results.
Results to date are incomplete in that the amount of
material examined, and the conclusions fairly drawn therefrom
are insufficient to allow one to propound a scheme of treatment
applicable to, and curative of, every case.
I would therefore recommend that further observations
towards the possibility of application, of the various
Sulphanilamide group drugs in different stages of gonococcal
infection, as follows:-
(a) '693' in Immediate or Delayed Cases.
(b) Sulphanilamide or Uleron in Delayed Cases.
(c) All three drugs, individually of course, without irrigation
(d) Despite my disappointing results with Vaccine treatment, the
effect of early vaccine i;muno- response in the Delayed
group of cases.