16
Gonorrhœa and infections of the Genito-urinary system.— The gonococcus was isolated
from two cases of acute urethritis, but from the chronic cases, staphylococci and streptococci
alone were grown. The B. Coli was responsible for two cases of Pyelitis and one of Cystitis,
whilst streptococci were found in three similar cases. The vaccine treatment of these cases
was as successful as usual especially the B. Coli infections.
Case 60.—Gonorrhœal urethritis in a young person which resisted the usual local and
medicinal treatment. Autogenous gonococcus vaccine was prepared from the purulent dis--
charge and graduated doses commencing with 2½ million were given at intervals of five days
or more. One month and a half after beginning the injections when the 50 million dose had
been administered, the urethral discharge was examined and found to be free from gonococci.
Five weeks later still after reaching the 125 million dose gonococci could be distinguished in
the discharge which contained many pus cells as well. The 750 million dose was reached at
the end of five months of treatment and the patient has remained quite well afterwards.
This case is an illustration of the apparent recovery alternating with relapses in the course
of treatment of acute gonorrhœal urethritis merging into the sub-acute and the chronic
stages. No patient should be declared clear of gonococci unless he is observed repeatedly for
a continued period of time, during which the vaccine treatment should be pushed to its
maximum dosage.
Case 67.—Pyelitis in a young man of 24, which began as a sequala of acute dysentery, with
pain in the loins, pus in the urine and occasional retention. The streptococcus was isolated
from a sample of the urine sent by post to the laboratory and an autogenous vaccine made
and supplied. The urine cleared up very quickly as soon as the injections were begun and
the patient was fairly convalescent after the fifth injection of 35 million streptococci. This
case is interesting being a streptococcal infection unlike the general class of cases of pyelitis
which are due to B. Coli infections.
Case 68.—One of coli pyelitis resulting from a chill and ushered in with the usual rigors
and fever. The condition resisted the usual antiseptic treatment with uratropine, ammonium
benzoote, etc. Recourse was therefore had to autogenous B. Coli vaccine. The recovery was
rapid and after nine injections the case is reported to have been completely cured.
TABLE IX.
Infections of the urinary tract and gonorrhœa.
Serial
num-
ber.
Case
num-
ber.
Medical Officer.
Disease.
Vaccine made.
Result.
1
4
District Medical and Sanitary Officer,
Cocanada.
Chronic urethritis . . .
Staphylococcus albus
and streptococcus.
No benefit.
2
11
Dr. T. V. Subba Rao, Triplicane . . .
Chronic gonorrhœal
urethritis.
Streptococcus . . .
Improved.
3
60
. . .
Gonorrhœal urethri-
tis.
Gonococcus . . .
Cured.
4
62
Superintendent, Government Maternity
Hospital, Madras.
Pyelitis . . .
B. Coli . . .
Do.
5
67
Dr. A. V. Subrahmanya Ayyar, State
Hospital, Chittoor-Palghat.
Do. . . .
Streptococcus. . .
Do.
6
68
Dr. P. R. Subba Ayyar, Trivandrum . . .
Chronic pyelitis . . .
B. Coli . . .
D o .
7
70
Superintendent, Government Maternity
Hospital, Madras.
Pyelitis. . .
Streptococcus . . .
Not used.
8
75
Dr. A. V. Subrahmanya Ayyar, Cochin.
Cystitis . . .
Do.. . .
Not known.
9
100 Dr. Hall-Wright, Sonari, Assam . . .
Gonorrhœal urethri-
tis.
Staphylococcus albus.
. . .
10
118 Dr. P. R. Subba Ayyar, Trivandrum . . .
Do.
Gonococcus . . .
Not known.
11
122
Dr. E. R. Warriar, Calicut . . .
Cystitis . . .
B. Coli . . .
Do.
Miscellaneous cases .—Of the twelve cases of other infections for which autogenous
vaccines were made, three cases deserve particular mention.
Case 24.—Europen female of 33 years, who had suffered for 18 months from ulcerative
colitis, with the passage of mucus and blood in the stools. There was also a history of con--
stipation alternating with diarrhœa for some years past. A non-lactose fermenting organism
was isolated from the mucus, the sugar reactions of which were almost identical with those of
Morgan's Bacillus No. 1. After a course of ten injections, lasting over a period of seven
weeks, both blood and mucus disappeared from the stools and a decided improvement in the
patient's general condition was also noticed.
Case 61 is worth recording as in the opinion of the Medical Officer in charge, it is
an instance of the efficacy of curative vaccine treatment in enteric. The patient was a sepoy
of the 80th Carnatic Infantry who suffered from a typical attack of enteric, the B. Typhosus
having been isolated from the blood on the sixth day of fever. On the 21st day he was in a
typical typhoid state, dull and apathetic, refusing food and lying in bed, quite irresponsive