16
Diseases of bones and joints.— Of the 6 cases treated, 2 were of tubercular caries with
secondary streptococcal infection. Both improved under autogenous streptococcus vaccine
treatment. Three were cases of chronic rheumatism from the uriń e of which attempts were
made to isolate the staphyloid coccus described by Crowe. Though no organisms answering to
his description could be isolated in any of the 3 cases, vaccines from a staphylococcus isolated
from the urine were tried. Two of the cases improved, but how far as a result of the vaccine
treatment, is doubtful.
Case 8 was one of acute periostitis of the femur in a boy of 14 years. The whole of the
shaft of the femur was involved and the temperature ranged between 101° and 104° F. The
swelling was incised and drained and a dose of 5 million autogenous streptococcus given.
The temperature fell down to normal after the first injection and the operation wound rapidly
healed in three weeks during which five injections up to 30 million were given. This case is
interesting as the result, both of the cultivation and of the autogenous vaccine treatment, indi
- c a t e s w h a t a n i m p o r t a n t p a r t s t r e p t o c o c c i p l a y i n b o n e i n f l a m m a t i o n s .
TABLE IX.
Disease of bones and joints.
Serial
n u m - b e r . . .
Case
num-
ber.
Medical Officer.
Disease.
Vaccine.
Result.
1
8 The Third Surgeon, General Hospital,
Madras.
Periostitis of femur.
Streptococcus . . . Cured.
2
20
Do. do.
Necrosis of os calcis.
Do. . . . Improved.
3
91 Dr. F. R. Carreck, Kotagiri . . . Chronic rheumatism. Staphylococcus . . .
Do.
4
132 The Third Surgeon, General Hospital,
Madras.
Caries of spine . . .
Streptococcus brevis.
Do.
5
148 The First Physician, General Hospital,
Madras.
Rheumatoid arthritis. Staphylococcus albus. Doubtful.
6
53
. . .
Rheumatism . . .
Streptococcus . . . Improved.
Gonorrhœal infections.— In this class of cases are included not only purely gonococcal
infections of the urethra but secondary infections with staphylococci and streptococci which
sooner or later supervene in the great majority of instances, as the trouble reaches the sub
- a c u t e a n d c h r o n i c s t a g e . I t i s u s u a l w h e n c u l t i v a t i o n s a r e m a d e f r o m t h e d i s c h a r g e i n t h e s e
latter to find more than one kind of organism in the cultures so that it is not always possible
to judge what part each plays in the inflammatory process. It is certain that, though the
gonococcus cannot be grown in the later stages of the disease, the organism is usually present
in the lacunæ and the patient is infective in the true sense as regards the gonococcus. Herein
probably lies the explanation of the want of uniformity in the results obtained by the use of
the secondary vaccines and the constantly successful results with the autogenous gonococcus
vaccines. Whenever the gonococcus cannot be isolated in such cases, it may therefore be a
wise thing to combine the secondary vaccine with a polyvalent stock gonococcus vaccine.
Case 64 is an instance of gonococcal cystitis. The patient, a girl of 15 years, was
suffering for three months from the bladder infection. The purulent deposit from the urine
contained large numbers of gonococci. The autogenous vaccine was injected in doses of 2
to 10 million organisms. The administration of six doses in eighteen days sufficed to cure the
condition which till then had resisted all medicinal and topical treatment.
TABLE X.
Gonococcal infections.
Serial
num-
ber.
Case
num-
ber.
Medical Officer.
Disease.
Vaccine.
Result.
1
38 The Officer Commanding Station Hos-
pital, Poonamallee.
Gonorrhœal ureth-
ritis.
Staphylococcus albus. Temporary
improve
-
ment.
2
64 The Superintendent, Maternity Hospi-
tal, Madras.
Gonorrhœal cys
-titis.
Gonococcus . . .
Cured.
3
67 The Officer Commanding Station Hos-
pital, Poonamallee.
Gonorrhœal ureth-
r i t i s .
Staphylococcus albus. Not known.
4
79
Do. do.
Do.
Do.
No effect.
5
94
Do. do.
Do.
Gonococcus . . . Cured.
6
95
Do. do.
D o .
Do. . . .
Do.
7
102
Do. do.
Do.
Staphylococcus . . . Doubtful.
8
103
Do. do.
Do.
Do. . . . Marked im
-provement.
9
114
Do. do.
Do.
Gonococcus . . . Cured.