17
TABLE XIII.
S e r i a l n u m b e r .
Case
Number.
Medical Officer.
Disease.
Vaccine made.
Result.
1
4
Dr. A. Lakshmi Pathi, B.A.,
M.B.,C.M., Madras . . .
Pyorrhœa alveolaris. Streptococcus brevis.
No effect.
2
33
Second Physician, General
Hospital, Madras
Do.
Do.
Improved.
3
44
District Medical and Sanitary
Officer, Trichinopoly.
Do.
Streptococci . . . Cured.
4
57
Assistant Surgeon S. P. Sarma,
Dindigul.
Gingivitis . . . Streptococcus . . . Cured.
5
60
Resident Medical Officer, Gene-
ral Hospital, Madras.
Pyorrhœa alveolaris. Streptococci . . . Improved.
6
62
District Medical and Sanitary
Officer, Madura.
Do.
Do. . . .
N ot given a fair trial.
7
91
District Medical and Sanitary
Officer, Madura.
Do.
Streptococcus . . .
Do.
8
101
District Medical and Sanitary
Officer, Madura.
Do.
Do. . . . Improved in general
health; better appe
-
tite.
9
109
Dr. A. A. Mix, D.D.S.,
Egmore.
Do.
Do. . . . Doubtful.
10
124
Second Surgeon, General Hos-
pital, Madras.
Do.
Do. . . . No effect.
11
134
Surgeon, First District, Roya-
puram.
Do.
Streptococcus brevis.
Improved.
12
180
Medical Officer, Municipal
Hospital, Madura.
Do.
Streptococcus . . . Slight improvement in
general health.
13
193
District Medical Officer, Trich-
nopoly.
Do.
Do. . . . Not known.
Inflammations of the nasopharynx and antral suppuration.— Of the 15 cases of nasal catarrh
and hay fever treated during the year six were pneumococcal in origin. In six cases streptococci
only were isolated; in two the streptococcus was associated with the micrococcus paratetragenus, an
organism which as will be seen presently, is found in a certain percentage of catarrhal inflamma
- t i o n s o f t h e b r o n c h i a s w e l l . I t i s a G r a m n e g a t i v e o r g a n i s m b u t i n s p e c i m e n s n o t f r e e l y
decolorized with absolute alcohol it is very apt to be mistaken for a faintly Gram positive coccus
of the ordinary staphylococcal type. In microscopic preparations of the mucus it shows a tend
- e n c y t o g r o u p i t s e l f i n t o p a i r s , t e t r a d s a n d c l u s t e r s , t h e l a t t e r n o t b e i n g i n t h e s h a p e o f b u n c h e s
of grapes but in rectangular or discrete and irregular formations. A flattening of the adjacent
surfaces of the cocci is sometimes observed. Both in the discharge and in cultures the organism
is as a rule larger in size than the staphylococcus pyogenes. It grows freely on ordinary agar
as thick opaque white or yellowish white colonies of medium size, the individual colonies in the
same culture often varying considerably in size suggesting impurity of culture. The growth
sticks to the surface of the agar in coherant masses which peel off in flakes making it rather
difficult to prepare a homogeneous vaccine-emulsion even after considerable shaking and stirring.
Broth cultures exhibit a similar tendency to formation of a heavy granular deposit with a more
or less clear supernatant fluid The organism ferments glucose and maltose but varies as
regards its action on the other sugars. It is culturally more delicate than the staphylococcus
d y i n g o f f u n l e s s s u b e u l t i v a t e d e v e r y f e w d a y s .
In one case of nasal catarrh a diphtheroid bacillus was found as the predominant growth
in the cultures. In this case, the culture tubes were inseminated in one of the mofussil stations
and despatched to the laboratory by post so that it is impossible to say whether, in case cultiva
- t i o n s w e r e m a d e i n t h e l a b o r a t o r y i t s e l f , a m o r e d e l i c a t e o r g a n i s m l i k e t h e p n e u m o c o c c u s c o u l d
not have been isolated. Unfortunately the result of treatment in this case could not be obtain
- e d a n d n o o p i n i o n c o u l d b e g i v e n r e g a r d i n g t h e c a u s a l r e l a t i o n s h i p o f t h e o r g a n i s m t o t h e
disease.
It will be seen by an analysis of the above 15 cases that the micrococcus catarrhalis is con
- s p i c u o u s b y i t s a b s e n c e i n n a s a l c a t a r r h . F o r s o m e r e a s o n s i t w a s n o t t i l l l a t e i n t h e y e a r t h a t
this organism was at all isolated in the laboratory and it is therefore likely that it has been
missed in some of these rhinitis cases and one is not justified in concluding that the organism
is not found in catarrhal conditions of the nose in this country.
On account of the inadequacy of information supplied regarding the result of vaccine
treatment in the above cases no definite conclusions can be come to regarding the efficacy of the
treatment.
Cases 108 and 110.—Recurrent attacks of catarrh of the pharynx with congestion of the
soft palate and a certain amount of local uneasiness during the attacks. Streptococci were iso
-lated in both the cases from which vaccines were prepared and administered. A general
improvement in the condition was noticeable as a result of the vaccine treatment and there has
been no recurrence.
5