14
the results obtained by the vaccine therapy of these obstinate diseases during 1914. Thirty
-
six cases were examined in all. The bacteriological findings and results of autogenous
vaccine therapy can be tabulated as follows:—
Organisms isolated.
Total
number
of
cases.
Cured or
greatly
improved.
Improved.
No
effect.
Vaccine
not used
or result
not
known.
Pneumococcus . . .
6
. . .
1
2
3
Pneumococcus and M. Catarrhalis . . .
2
1
. . .
. . .
1
Pneumococcus, M. Paratetragenus and streptococcus . . .
1
1
. . .
. . .
. . .
Pneumococcus and streptococcus . . .
1
. . .
. . .
. . .
1
Streptococcus . . .
13
7
2
2
2
M. Catarrhalis . . .
2
. . .
1
. . .
1
M. Catarrhalis and streptococcus . . .
2
1
. . .
. . .
1
M. Paratetragenus . . .
1
. . .
1
. . .
. . .
M. Paratetragenus and streptococcus . . .
8
3
1
1
3
As was observed last year the Pneumococcus and streptococci have been found in the
sputum more frequently than the other organisms, the former having been isolated in 10 cases
and the latter in 24, either alone or associated with other organisms. The majority of cases
reported as cured or greatly improved were streptococcal and this seems to indicate that the
streptococci do after all play a truly pathogenic part in these respiratory catarrhs and that the
number of these streptococcal cases is perhaps much greater than was originally supposed.
On account of the disappointing results obtained at an earlier stage with autogenous strepto
-
coccal vaccines in asthma and chronic bronchitis, the bacteriological findings in this class of
cases was at first viewed with some suspicion and whenever the streptococcus alone was
isolated from a sputum it was feared that the real organism was for some reasons missed. It
is clear that this view was rather premature and that streptococci do play as important a part
in the pathology of bronchial catarrhs as other organisms.
Of the 24 cases in which the reports of the results of vaccine treatment could be obtained,
13 were either cured or greatly improved ; 6 showed some improvement and the remaining
5 derived no benefit. In a paroxysmal and recurring disease like asthma, with intervals of
comparative and even absolute quiet, it is perhaps rather presumptuous to assert that a case
has been cured, unless the patient has been kept under observation for a long period, during
one or two cold seasons say, but there are o ń e or two cases whose history is sufficient to dispel
all scepticism. These have now been under observation for two or three years and as their
trouble was of such a virulent type, that marked relief for any length of time under medicinal
treatment had been unknown for years, their practical freedom during such a prolonged period
can only be attributed to the treatment with bacterial vaccines.
One was a young lady, for a long time a resident of Secunderabad, who was afflicted with
a very severe type of bronchial asthma which was now and again complicated with pneumonic
attacks with rise of temperature and general prostration. As there was a history of phthisis
in the family, it was even feared that she was a consumptive subject. She came to Madras in
October 1912 for vaccine treatment which was begun with an autogenous streptococcal vaccine,
no pneumococcus having then been isolated. This was probably due to the very delicate
Pneumococcus having died out in transit to the King Institute from the General Hospital
where she was an in-patient. As this vaccine did not work satisfactorily., a stock pneumococcus
vaccine was combined with it and the patient got so well that she left for Ootacamund in
search of employment. She spent the cold season in the Nilgiris without being very much
affected by the rigorous weather. Early in 1914 she left for Calcutta. On her way she
visited the Institute to give material for the preparation of a fresh autogenous vaccine, the old
one having run short. The cultures thus made under clinical conditions yielded the
Pneumococcus, a streptococcus and M. Paratetragenus, and a combined vaccine was prepared.
Before a fair trial could be given to this new vaccine, the damp climate of Calcutta produced
a deleterious effect on her lungs and she had a relapse of some severity which necessitated her
going into the Calcutta General Hospital. She soon recovered from the acute attack and has
been continuing the course of injections with the new vaccine with such gratifying results that
for nearly a year she has been free from cough and hard breathing.
Another case was in that of a Civilian who, for over ten years, was troubled with a
continuous bronchial catarrh with such asthmatic exacerbations during damp weather as to
make sleep at night almost impossible. The pneumococcus was isolated in pure culture from
his sputum. A long course of the autogenous pneumococcus vaccine produced such a marked
effect on his catarrh that during the last two years of his service in India he was practically
free from the cough and asthma, and the rainy weather of the hills during the summer did
not affect him at all. With his previous experience of the uselessness of medicinal treatment
he wasthoroughly satisfied that it was the vaccine treatment, and nothing else, that had brought
about such a markedly beneficial effect on his lungs.