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undoubtedly due to vaccine treatment. The following case is also interesting being one of the
subacute forms in which it was possible to prepare the autogenous vaccine in time to be used
before the graver symptoms supervened.
Case 133 —A nurse pricked her thumb accidentally with the hypodermic needle used on. a
case of septicæmia. Though the puncture was immediately cauterized with carbolic acid, septic
inflammation set in within 24 hours. The swelling and pain extended up the forearm during
the next six days and the temperature rose to 103° F. Stock streptococcus vaccine was found
ineffectual and an autogenous vaccine was made. One dose of this vaccine along with vigorous.
local antiseptic treatment brought about a complete recovery. Though it cannot be definitely
stated that the vaccine played an essential part in the progress of the case, the fact that imme--
diate and intense disinfection of the primary - wound failed to prevent the onset, points to
there having been a powerful auxiliary to the later antiseptic treatment.
Pyorrhœa Alveolaris.— Seven cases of the disease came under observation. A streptococcus
was invariably the organism isolated. In the last case an anærobic cultivation was also made
with a negative finding. As no reports have yet been received regarding the result of treatment
in six of these cases, no conclusion could be drawn regarding the bacterial treatment of this most
obstinate condition.
Cystitis and Pyelitis were usually found associated with a bacillus of the coli group, staphy-
-lococci and streptococci being the other organisms found in the urine. The bacilli isolated from
cases 36 and 38 were probably extraneous ones derived from the bottle in which the urine was
collected. The gonococcns was isolated in pure culture from a case of cystitis in a female (case
165).
Case 4.—An old man, aged 70 years with enlarged prostate and dysuria. The urine had
to be drawn off by catheter. The prostrate was removed by operation but the temperature rose
after the operation, going up to 101° from the sixth day. A dose of 20 million autogenous
coli vaccine brought down the temperature to normal within 24 hours and the patient made
a steady recovery within one month after the operation. He received four inoculations during
that period ; the highest dose being 200 millions.
Case 8.— A female aged 33 years had suffered from pain in the right lumbar region for
seven years and about five years ago was operated on for floating kidney. Cultures made from
the urine shewed a preponderant growth of staphylococcus albus. After four injections of the
autogenous vaccine in doses of 50 to 100 millions the patient was free from renal pain.
Case 54.—Acute cystitis which developed three days after the crisis of an attack of
pneumonia. The staphylococcus aureus was isolated from the urine and three doses (20, 50 and
100 millions) were injected with the result that the urine was quite free from pus 3 days after
the third dose.
Case 115—chronic cystitis of 5 years' duration. Urine passed about 20 times in the day
and 15 times at night. It was scanty, light colored and alkaline and contained pus cells.
Irrigation of the bladder and internal medication were of no avail. After a series of 12
injections of an autogenous streptococcus vaccine (5 to 200 million) the frequency of micturition
came down to 8 times in the day and 5 or 6 times at night. The urine cleared up and became
acid and the patient was discharged considerably improved.
Case 144—Acute pyelitis with irregular intermittent fever and bacilluria. Under medical
treatment the fever and general symptoms were relieved but the bacilluria persisted. B. Coli
Schaefferi was isolated from the urine in pure culture. Two doses of autogenous vaccine (5 and
15 million) resulted in a cure.
Case 156.—A student aged 19 years suffered from haematuria for one week with pain
during micturition, frequency 20 times a day. The urine contained leucocytes, epithelial cells,
red corpuscles and motile bacilli. A quotidian type of fever supervened the temperature going
up to 103° F. B. Coli (Esoherich) was isolated from the urine and a vaccine in doses of 5
million, 12 million, 25 million and 50 million at intervals of 3 to 5 days gave a complete cure,
the urine clearing up and the cellular elements disappearing from it as the treatment
progressed.
Case 160—Admitted with bladder symptoms and pain along the left Sciatic nerve. The
prostate was enlarged and the urine contained pus, epithelial cells and bacilli. B. Coli (71) was
isolated. A. dose of stock coli vaccine had previously been used without benefit. The
autogenous vaccine was administered in 4 doses (8 to 50 million) at intervals of 3 or 4 days and
the patient was discharged " practically cured " 5 days after the last dose.
Gonococcal infections.—One strain of gonococcus was isolated from a case of acute urethritis
in a male and another from a case of acute cystitis in a female. The urine in the latter was
loaded with pus from which a pure culture of the Diplococcus gonorrhoeae was obtained. In
two cases of chronic urethritis resulting from old gonococcal infections, a diphtheroid bacillus
was present, in one a staphylococcus albus and in a fourth a staphylococcus aureus. There seems
to be no doubt that in the later stages of gonorrhoeal urethritis the urethral mucous membrane
becomes so unhealthy and vulnerable that extraneous organisms readily invade it and soon
outgrow the gonococcus. This makes it practically impossible to isolate the latter organism
from the discharge and probably explains why in many cases of urethritis of a subacute and