A CLINICAL STUDY OF RHEUMATOID ARTHRITIS
Authors: A. H. Douthwaite
Journal: BMJ (1925)

J~~_ORA Case 6.-Mrs.K., aged 83.Attack of fever suggesting influenza or appendicitis.Temperature 1010 F. Pus, B. coli, and staphylococci in urine.Temperature normal three weeks after beginning of attack.Ten days later collar-gol injected.Urine not sterile till fifty-sixth day of treatment.Injections almiost, but not quite, daily, the strength of collargol varying from 0.5 to 2 per cent.and even 4 per ceint., but strong solutions made matters worse.Urine sterile many months after cessation of treatment.Cases 7.-Mrs.M., aged 18. Staphylococcus infection.In-patient in Lonidon Temperance Hospital for three weeks.Treated with oral adminiistration of drugs.Collargol injections in out-patient departlment produced cure in ten to fouirteen days.Case 8.-Miss E., aged 35.Urine infected with streptococei and B. coli.Collargol 1 per cent.cured the condition in about a month.Case 9.-Mrs.T., widow, aged-65.Cystitis since removal of an innocent intravesical.growth in Guy's Hospital three years pre- viously.Frequent micturition, pus, and B. coli.Collargol 1 per cent.injections.Urine free from pus and sterile after nine days' treatment.Treatment discontinued on the twelfth day; urine s6ill sterile on the seventeenth day, and no return of symptoms up to time of her death from pneumonia six months later.Case 10.-Woman, aged 65; in-patient in London Temperance Hospital.First had difficulty in micturition in 1918; curetted April 12th, 1923.On April 19th painful micturition, pus, and B. coli in urine.From April 30th till May 14th collargol 1 per cent.daily.On June 15th only four colonies of staphylococci on agar inoculated with loopful of deposit.On May 23rd culture revealed a few staphylococci and B. coli in urine.She had no further treatmexnt arid was discharged.Three weeks later reported by medical attendant to have another attack of " cystitis."Case 11.-Married woman, aged 43; in-patient in London Temperance Hospital.Hysterectomy, April, i923.Just prior to operation urine " strong-smelling."On May 1st the urine con- tained pus and B. coli.Collargol 1 per cent.given for three to four weeks without much improvement.(Twelve months later no pus in urine, three or four colonies of Staphylococcus albus developed from loopful of deposit.)Case 12.-Woman, aged 41; in-patient in London Temperance Hospital.Pus aind B. coli in urine.Collargol 1 per cent.injections rendered urine sterile in approximately fourteen days.Case 13.-Married woman, aged 33; in-patient in London Tem- perance Hospital.Febrile attack; pus, B. coli, and staphylococci in urine.On the tenth day, when the temperature had fallen to normal, collargol injections begun.Strength varied from 0.5 to 2 per cent.A month's treatment had not rendered the urine quite sterile, nor free from pus cells.Case 14.-Married woman, aged 47; in-patient in London Tem- perance Hospital.Frequent painful micturition ten months prior to operation for a large uterine fibroid, which was followed by phlebitis.Urine examined two months after operation contained blood, pus, B. coli, staphylococci, and diphtheroid bacilli.Collargol injections persisted in for about ten weeks, with one or two in.terinissions,resulted in considerable improvement, but not cure.Case 15.-Married woman, aged 49; in-patient in London Temperance Hospital.Operation March 27th, 1924-amputation of uterine cervix, colporrhaphy and perineorrhaphy.Had had discomfort in bladder for three years.On April 14th much pus and B. coli in urine.On April 19th inijections of collargol begun and continued till May 12th, when neoprotosil 10 per cent.was substituted for the collargol.Treatment discontinued on May 15th, and patient discharged from hospital on May 22nd, when no B. coli were present in the urinie.