10
REPORT OF THE KING INSTITUTE, GUINDY
comparative doses of each are being studied. So far no difference has been
noted with the two strains investigated.
(8) The reaction to vaccines.—We have received complaints from time to
time of severe local reactions following the use of stock cholera or T.A.B.
vaccines, more particularly of delayed local reactions giving a swelling of the
arm about a week after inoculation. Accordingly Dr. Martin has been trying
to see what can be done to diminish these reactions without diminishing the
antigenic power of the vaccine. A diminution of the reaction can easily be
obtained by pouring off most of the supernatant fluid of the vaccine when first
made thus letting the vaccine consist mainly of the bodies of the bacteria. But
this is a process which certainly throws away antigenic substances of great value
as was shown by Ferry and Fisher some years ago. Similarly, Dr. Martin finds
that the serum of rabbits inoculated with the supernatant clear fluid of cholera
vaccine (from an emulsion from a 24-hour Douglas agar growth) shows bacteri-
cidal and agglutinating properties against cholera vibrios. I had the idea that
possibly some of the reaction is due to the inclusion of proteins derived from the
culture medium. So we have been seeking to diminish in the vaccine the amount
of protein that has been so derived. We now use saline instead of broth for
washing away the growth from the primary seed culture tubes. We also throw
away before inoculation the water of condensation in the larger bottles in which
growth finally occurs, for we find the water of condensation to be very rich in
both proteins. The inquiry is being continued.
(9) Cases of interest in the clinical bacteriological section reported by Rao
Bahadur Dr. T. Sitapati Ayyar.—(a) Cases of chronic rheumatism cured by
vaccines of M. deformans and enterococcus. Mr. W. was suffering from chronic
Lumbago and sub-acute rheumatic pains in the big joints and intercostal muscles
following nasal catarrh and frontal sinusitis. No relief had been obtained from
ordinary medicinal treatment, intestinal antiseptics, diathermy and ionisation.
On the advice of Lt.-Col. Skinner, a course of treatment with a stock
vaccine of M. deformans commencing with small doses of 20,000 and gradually
working up to 100,000 organisms was given. His Lumbago and joint pains
were completely relieved but the muscular pain remained. An auto-vaccine from
an enterococcus from his stools was made which practically cured him of the
latter pains. This case is of interest in showing the rheumatoid pains are perhaps
due to more than one organism. We have had a good deal of success with
vaccines for arthritis, etc., since following Dr. Warren Crowe's methods.
Another interesting case was Major W. who had suffered from Lumbago
and subacute pains in the joints for ten years. Various medicines and stock
vaccines had had no effect. An auto-vaccine of an enterococcus made from his
stools relieved him of practically all pains.
(b) Autoproteose in allergic condition.— An investigation into the thera-
peutic effect of autoproteose made from the urine of patients suffering from
allergic conditions such as Asthma, Psoriasis Urticaria and different kinds of
dermatitis was started during the year. The main results so far are that it is
chiefly in the skin disease group that a good effect is obtained.
(b) A case of dermal leishmaniasis with leprosy.—Mr. J. had a very
chronic pigmented nodular patch over the alæ and tip of the nose, and unpig
- m e n t e d s m a l l e r
n o d u l e s
o v e r t h e l i p s a n d e a r s i n a d d i t i o n t o d e p i g m e n t e d p a t c h e s
of various sizes over the skin of the extremities and trunk. Microscopical
examination of scrapings from the different lesions revealed Leishman Donovan
bodies in the nodules of the nose and lepra bacilli into the nodules over the lips and
ears. Thus the patient was suffering from a mixed infection of dermal Leish-
maniasis and leprosy—a rare and interesting condition. The patient's blood
was sent to Dr. Row of Bombay who kindly did an agglutination test on his
laboratory strain of leishmaniasis and found a distinct positive reaction in a
dilution of 1 in 30 in 4 hours. Another interesting feature observed in this case
was that the patient had given a definite previous history of an attack of Kala
- a z a r d u r i n g t h e y e a r s 1 9 0 9 a n d 1 9 1 0 , w h e n p a r a s i t e s w e r e f o u n d i n s p l e e n
puncture by Col. Donovan. The disease is said to have been cured then, but in