X i i
again are excessively delicate and may die out as a result of a short exposure to a lower te
m - p e r a t u r e t h a n t h a t o f b l o o d h e a t . T h e b e s t r e s u l t s w i t h t h e s e o r g a n i s m s a r e t o b e e x p e c t e d i f
the cultures are made clinically and then conveyed in a portable incubator to the laboratory
for further study.
Gonococcus vaccine—was greatly in demand and was used on a large scale in the Govern-
ment Voluntary, Venereal Hospital. The results obtained there were not however very encou-
raging. This may have been due to the strains used having lost their virulence by subculture.
New strains are now being collected and a fresh stock of gonococcus vaccine made. From the
statistical report supplied by the Superintendent of the Government Voluntary Venereal Hospi-
tal, it is seen that out of 22 cases of sub-acute and chronic gonorrhoeal infections placed
under vaccine treatment in that institution, 4 were completely cured, 7 improved, 7 obtained
no marked benefit and 4 discontinued the treatment before it could possibly do good. Judging
by the excellent results reported from the use of the vaccine as it was made from the original
gonococcus cultures last year, it is probable that the diminished efficacy is due either to a falling
off in the virulence of the strains or to some other cause the nature of which has yet to be
ascertained.
Coli vaccines.—Under this heading have been included vaccines made from lactose
fermenting coli-form bacilli isolated from three cases of bacillary and two of liver abscess.
Classified by McConkey's method, i.e., by t h e i r b i o - c h e mi c a l r e a c t i o n i n d i f f e r e n t s u g a r me d i a , i t
was noticed that with the exception of B. Lactis aerogenes isolated in two instances no two of
the nine organisms concerned were identical, but the pathogenicity of the different types in the
respective conditions from which they were isolated seemed to be proved by the excellent results
obtained by vaccine treatment in these cases (vide cases 22, 32, 91 and 62).
Typhoid vaccines .—A polyvalent vaccine made from five different strains was supplied in
prophylactic doses of 500 millions, 1,000 millions and 2,000 millions. A few curative doses of
50—200 millions were also sent out to some of the hospitals of Madras City.
Tuberculin (Koch's new tuberculin—Bacillary emulsion).—Dilutions of 1/50,000
inilligrammes to the c,c. and upwards were prepared from stock emulsions obtained from
European manufacturers. This, as well as Koch's old tuberculin, in capillary pipettes for Von
Pirquet's reaction, were supplied to private medical men as well as to public institutions.
Leprolin. —A few capsules of Captain Williams' ieprolin obtained from the Bombay
Bacteriological Laboratory were tried on a case of leprosy but without any noticeable benefit.
Dysentery vaccines. —During the latter half of the year under report an investigation into
the bacteriology of dysentery occurring in the Lunatic Asylum at Madras was begun not only
with the idea of ascertaining to what extent such cases of Institutional dysentery are bacillary
in origin but with a view to the preparation of a polyvalent vaccine for general use as a curative
in all dysentery cases supposed to be of bacillary origin. The isolation of a given organism
from stools is a rather complicated and delicate operation on account of the enormous numbers
and varieties normally present. These difficulties are probably enhanced where we are dealing
with pathological conditions of the intestinal mucous membrane and it took some time to get
into the proper technique.
As the material at our disposal was limited in amount, this enquiry cannot be considered
sufficiently exhaustive to support generalizations regarding the prevalence of bacillary dysen-
tery in Madras, but it does seem to indicate that B. Dysenterme is responsible for a large
percentage of cases.
What follows is a brief description of the technique employed. The whole stool or the
mucus collected from it was packed in ice and sent to the laboratory within a few hours of its
being passed. As soon as the material reached the laboratory a few flakes of mucus were taken
out and freely rinsed in sterile salt solution to wash off as many extraneous intestinal organisms
as possible. With these washed flakes smears were made on successive McConkey's plates with
a glass rod bent at right angles. Half a dozen plates were used for each sample of stool.
The first plate or two usually showed a confluent growth but on the later plates discrete colonies
developed. Colonies of B Dysenteriae made their appearance after 12 hours as tiny trans-
- p a r e n t ,
n o n - a c i d p o i n t s b u t a t t h i s t i m e c o l o n i e so
f a c i d p r o d u c i n g c o l i f o r m o r g a n i s m s h a d
already reached a fair size and had developed a red color either on their whole surface or at
their summits. At the end of 24 hours the colonies of B. Dysenteriae were still small in size
but sufficiently large to be easily perceptible to the naked eye. The colonies were picked out
and examined for motility under the microscope and at the same time 12 to 20 or more were
planted into tubes containing lactose, neutral red, peptone water, to make sure that they were
really non-fermenters of lactose. Twenty-four hours later, sub-inoculations were made from the
lactose medium into Durham's glucose, neutral red, fermentation tubes and only such colonies of
non-motile bacilli, as were found not to ferment lactose but to ferment glucose without gas
production, were kept for further investigation as to their agglutination properties, etc. One
interesting characteristic noticed regarding the cultural reaction of B. Dysenteriae was that
though the organism was a non-lactose fermenter a very faint trace of acidity was noticeable in
In one case a culture of the mucus made on McConkey's bile salt, lactose, neutral red agar plates was received
f r o m u p - c o u n t r y b y p o s t , a n d f r o m s u b - c u l t u r e s ma d e f r o m t h e c o n f l u e n t g r o w t h o n t h e s e , B . D y s e n t e r i a e w a s i s o l a t e d .