11
REPORT OF THE KING INSTITUTE, GUINDY
1914 after a period of 5 years the dermal Leishmaniasis started over the nose.
A year later the leprotic patches were observed.
(10)
A modification of the Widal reaction for the enteric group.—In addition
to the saline suspensions of 24-hour cultures of B. typhosus which are used in the
routine Widal tests, Dr. S. R. Pandit has been employing this year suspensions
of the " O " antigen. This has been found to be an efficient check on the Widals,
and in a few cases an infection of typhoid has been detected which would other
-wise have been missed by the employment of the older method alone.
(11)
Serum reactions.—The following table gives the results in those cases
in which both Kahn and Wassermann tests were done:—
Kahn.
Number of
tests.
Percentages of Wassermann f i n d i n g s .
N e g a t i v e .
Positive
weak.
Positive
strong.
Total
positives.
N e g a t i v e . . . 308
92
7
1
7
I n d e t e r m i n a t e . . . 1,966
49
22
29
51
+ Weak positive . . .
1,928
25
27
48
75
+ + Strong " . . .
1,578
10
31
59
90
Total, positive
K a h n s . . . 3,506
18
29
53
82
per cent.
Grand Total . . .
5,472
29
27
44
71
The number of negative Kahns on which Wassermanns were also done is
small, because our routine is, that unless specially asked, we do not do a Wasser
- m a n n t e s t w h e n t h e K a h n t e s t i s n e g a t i v e , b u t o n l y d o a W a s s e r m a n n w h e n t h e
Kahn test is positive. Our nomenclature here of the Kahn findings is in
agreement with the resolutions of the last League of Nations Special Health
Committee, i.e., the "indeterminate" reaction is that which formerly used to be
given a single + and called "weak positive" and so on. The negative Wasser
- m a n n s i n c l u d e a f e w i n d e t e r m i n a t e f i n d i n g s w i t h o n l y p a r t i a l l y s i s . A s s e e m
from the penultimate row of figures 82 per cent of definitely positive Kahns
gave a definitely positive Wassermann. While this shows a much closer
correspondence between the two tests than in previous years, one would prefer to
see a still closer correspondence. As regards correspondence with clinical findings,
Dr. Happer, the Venereal Diseases Specialist in a special comparison of tests with
clinical findings in Madras finds that of 206 cases considered positive clinically
5 per cent were reported Kahn negative. Of 707 cases considered clinically
negative 28 per cent were Kahn positive with the present nomenclature (the
previous moderate and strong positive) and 13.5 per cent were both Kahn and
Wassermann positive. In assessing the value of these figures it must be
remembered that 10 per cent of the ordinary clientele of hospitals in Madras give
a Wassermann reaction. When the nature and limitations of these reactions and
the limitations of clinical findings are borne in mind, I think that the correspond
- e n c e b e t w e e n t h e r e a c t i o n a n d c l i n i c a l f e a t u r e s i s s a t i s f a c t o r y . T h o u g h a s l i g h t l y
closer correspondence would be obtained by doing both the Kahn and the
Wassermann tests in all cases, it is very doubtful whether it would be worth the
extra expense of doing so in all ordinary cases which total 24,000 or more
a year.
(12)
Technique of serum reactions.— Dr . Seshadrinathan has adopted the drop
method for the distribution of the Kahn antigen in the Kahn test. One drop,
two drops and four drops being equal to 0.0125, 0.025 and 0.05 c.c. respectively.
For this purpose a special pipette has been devised by him which is easily made
and enables the antigen to flow in uniform drops at a uniform rate. The drop
method has enabled a larger number of tests being done in a shorter time with
greater accuracy and with less fatigue.
(13) Trial of cholera bacteriophage for the prevention of cholera.— (a ) On the
occurrence of cholera in the Bellary district in November 1930 Dr. Satyanarayana
- m u r t i w e n t t h e r e a n d w i t h t h e c o - o p e r a t i o n o f t h e D i s t r i c t H e a l t h O f f i c e r
spread cholera bacteriophage in several water-supplies—this and other phages
2 - A