20
or more. This vaccine was used as a routine during an epidemic of pemphigus which broke
out among the Devonshire Regiment at St. Thomas' Mount and proved remarkably effective in
curing the large majority of the cases. A few who resisted the stock vaccine were success
-fully dealt with by autogenous vaccines.
An interesting case of acute pemphigus cured with polyvalent pemphigus streptococcus
vaccine is reported by the Superintendent of the Government Leper Hospital, Madras. A
patient developed acute pemphigus with bullæ all over the body accompanied by rigors and
hyperpyrexia. The mucous membrane of the mouth and pharynx was also affected. A course
of two to fifteen million of the stock pemphigus vaccine promptly cured the condition.
The stock compound catarrhal vaccine of the Institute made up of a number of strains.
of Pneumococcus, M. Catarrhalis and B. Influenzæ was used in cases of recurring nasopha
- r y n g e a l c a t a r r h s a n d i n c h r o n i c b r o n c h i t i s w i t h v e r y e n c o u r a g i n g r e s u l t s . T h e C i v i l M e d i c a l
Officer of Secunderabad reports that three cases of recurring colds were successfully cured
with a course of this vaccine.
Polyvalent gonococcus vaccine.—Increasing evidence is still accumulating year after year
of the marked efficacy of the vaccine in the metastatic gonorrhœal infections, viz., gonor
- r h œ a l s y n o v i t i s , a r t h r i t i s , f a s c i a i t i s , e p i d i d y m i t i s , e t c . T h e r e h a s , a s u s u a l , b e e n a d i f f e r e n c e o f
opinion regarding its utility in acute gono
rrhœal urethritis and in chronic gleet. Thus the
medical officers in charge of the venereal wards of the Station Hospitals of Bangalore and
Poonamallee consider that whilst the vaccine gave eminently satisfactory results in cases of
gonorrhœal arthritis and epididymitis, it had practically no effect in cutting short the course
of acute gonorrhœal urethritis though its employment in this stage was a sure preventive of
the later complications. For this reason the routine practice in these hospitals has been to
give every case weekly injections in an ascending scale 10, 20, 50, etc., up to 300 million or
more. The higher doses of 1,000 to 1,500 million are advocated by some as they consider
that a case cannot be declared as cured and free from infection unless the patient has been
immunized to this high degree.
Gonococcus vaccine was used in the Government Ophthalmic Hospital for a large variety
of pathological conditions of the eye including conjunctivitis, keratitis, episcleritis, iritis,
iridocyclitis and even optic atrophy. With the exception of the cases of acute gonorrhœal
conjunctivitis, no definite results were obtained in these conditions.
Tuberculin.—Of the doses of tuberculin issued a large number were of the diagnostic
material for Von Pirquet's reaction. A comparatively small number of doses for curative use
were supplied, indents having as a rule been complied with only when the Director was satisfied
that the cases for which tuberculin was ordered were fit ones for this special kind of treatment.
To enable the Institute to select such cases, the Medical Officer in charge of the case was
requested to supply information regarding the case on the following points: (1) whether
febrile or afebrile, (2) what organ or organs affected, (3) condition of the cardiac and renal
functions, and (4) general condition. In febrile cases, especially such as had daily maxima of
over 100° F. he was advised not to treat with tuberculin but to keep them under ordinary
treatment till the temperature steadied down to a normal of 99.5° F. Pulmonary cases were,
as far as possible, excluded from treatment by tuberculin, its administration being restricted
to cases with quite normal temperatures. On account of these restrictions the Institute
tuberculin was employed almost exclusively in surgical cases especially tubercular adenitis
with the result that the reports received were uniformly favourable.
Minute doses of 1/100,000 mgr. to 1/50,000 mgr. of bacillary emulsion were tried in the
Madras Ophthalmic Hospital in cases of strumous Keratitis. As the cases had the usual local
and constitutional treatment at the same time, it was not possible to say if the tuberculin
injections did these patients any good.