19
cases reported only 2 were declared unsuccessful, the remaining 22 cases being more or less
completely cured. On the other hand of 11 cases of urethritis, including acute and chronic
cases, 2 did not benefit at all and 9 improved to a greater or less extent, relapses having
occurred in a certain number of them after stopping the injections. It is interesting to note
how opinions are so varied regarding the efficacy of the vaccine in the primary urethral
infection. On the one hand it has been reported to have benefited or even cured cases of
chronic gleet with fistulæ, in some of such cases a polyvalent staphylococcus vaccine having
been used in combination with the gonococcus vaccine. On the other hand and especially by
Medical Officers using the vaccine on a large scale in the venereal wards of military hos
- p i t a l s , i t h a s b e e n d e c l a r e d t o b e o f n o a p p r e c i a b l e b e n e f i t i n c u r i n g t h e u r e t h r i t i s o r c u t t i n g
short the natural course of the acute urethral inflammation. The vaccine was found to be
effective as usual in the secondary inflammations of the prostate, epididymis, periosteum,
fasciæ, conjunctiva, etc. The administration of the vaccine does not as a rule seem to be
attended with reactions even when large doses are used and some of the chronic cases do in
fact require the ultimate application of such large doses as 1,000 million and even more.
Tuberculin.—Bacillary emulsion for curative treatment was issued on a much smaller
scale than in previous years, the supply of this vaccine being strictly refused to all febrile
cases. A combination of equal parts of the human and bovine bacillary emulsions was issued
in dilutions of 1/100000 mgr. to the c.c. and upwards. As a routine a commencing dose of
1/200000 mgr. of bacillary substance (=½ c.c. of 1/100000 mgr. to c.c.) was advised and
increasing doses of 1/100000 mgr., 1/75000 mgr., 1/50000 mgr., were supplied in sets of 4 to 6
doses at a time, the next supply of a further 4 to 6 doses being made only after obtaining a
report from the medical man in charge of the case that no unpleasant effects had followed
the use of the previous set of doses. In this way the disastrous results known to follow the
indiscriminate use of this potent vaccine were successfully avoided. In the selected cases of
tubercular adenitis wherein the bacillary emulsion was employed the effect produced on the
general condition of the patient was very favourable, the cases putting on weight and the
size of the glands decreasing to a greater or less extent.
As an instance of the possibility of the application of tuberculin therapy in pulmonary
infection, a case treated in the Pochirazu Hospital at Berhampur deserves a special mention.
It was a child of 14 years in a highly tubercular family whose right upper lope was affected
and the sputum contained tubercle bacilli. There was a concomitant cervical adenitis, as also
s l i g h t i n t e s t i n a l c a t a r r h . T h e d a i l y m a x i m u m b e i n g 1 0 0° F . o r l e s s , t r e a t m e n t w a s c o m m e n c e d
with 1/400000 mgr. of bacillary emulsion and the doses cautiously increased up to 1/1000
mgr. Twice or thrice in the beginning of the course a slight reaction with rise of
tempera-ture to 101° was noticed but the latter part of the course was marked by a steady progress of
the patient in all directions. The temperature gradually fell down to normal, the lung condi
- t i o n c l e a r e d u p , t h e t u b e r c l e b a c i l l i d i s a p p e a r e d f r o m t h e s p u t u m , t h e p a t i e n t p u t o n w e i g h t
and strength, the neck glands subsided, the diarrhœa ceased and the patient has remained
well for eight months after the end of the course. The usual dietitic and medicinal treatment
and an open air life were also responsible for this steady improvement but the medical officer
who was in charge of the patient was of opinion that the tuberculin was of decided value in
the progress of the case.