1 1
TABLE VI— cont.
Inflammations of the mouth, nose, throat, ear, conjunctiva and antrum —cont.
Serial
num
-ber.
Case
num
-ber.
Medical Officer.
Disease.
Vaccine.
Result.
6
115 The District Medical and Sanitary
Officer, Nellore.
Chronic otitis media. Diphtheroid bacillus. Improved.
7
122 The
Superintendent,
Government
Ophthalmic Hospital, Madras.
Recurring conjunc
-tivitis.
Staphylococcus albus. Cured.
8
126 The Medical Officer, Lawley Hospital,
Coonoor.
Suppuration of a
n-trum.
Pneumococcus . . . Improving.
Asthma, bronchitis and lung affections. —Of the 29 cases of this class treated with autoge
-nous vaccines 24 were cases of asthma and chronic or recurring bronchitis. The following is
the analysis of the cultural findings in these 24 cases.
cases.
Streptococcus only isolated . . .
3
Pneumococcus only isolated . . .
10
Mi c r o c o c c u s P a r a t e t r a g e n u s o n l y i s o l a t e d . . .
1
Micrococcus Catarrhalis only isolated . . .
1
Bacillus Influenzae only isolated . . .
2
Pneumococcus and streptococcus isolated . . .
3
Pneumococcus and Micrococcus catarrhalis i s o l a t e d . . .
2
Pneumococcus and Bacillus Influenzae isolated . . .
1
Pneumococcus, streptococcus and B. Influenzae isolated . . .
1
In conformity with the results obtained in previous years, the pneumococcus is found
t o
be the predominant organism in these cases of bronchial catarrh, 17 of the 24 harbouring this
diplococcus. The B. Influenzae was isolated in 4 cases either alone or in association with
other organisms. Though this organism was not isolated during previous years it is almost
certain that the failure to isolate it was not due to its having been absent in the specimens of
sputa but to the fact that blood agar media were not systematically used in cultural work
until this year. The B. Influenzae does not grow on ordinary agar, grows very scantily or not
at all on the hydrocele fluid agar used in the laboratory, but grows abundantly on blood agar,
this medium being made by smearing a drop or two of fresh rabbit's blood on each agar agar
slope. Even on this medium the organism sometimes shows marked idiosyncrasies as regards
growth, fresh sputum demonstrated microscopically to be full of B. Influenzae failing some
-
times to yield a growth of the organism. In such cases the attempt has to be repeated and
the organism can be cultivated almost to a certainty. The colonies on this blood agar are
small, transparent and rounded, unlike colonies of the Pneumococcus which tend to flatten
out as they grow.
From Table VII it is seen that in a large number of cases the treatment was reported
as ineffective, but a close scrutiny of such cases shews that in a large majority of them the
dosage was inadequate or the vaccine treatment was not sufficiently persevered with.
Case 80—was one of the laboratory staff who for the previous 3 or 4 years was subject to
recurring attacks of catarrh of the nose and throat spreading in the course of a day or two
into the trachea and bronchi on the one hand and into the frontal sinuses on the other, with
the attendant symptoms of persistent headache, lachrymation, and general constitutional
disturbance with respiratory symptoms of threatening bronchial asthma. A condition of acute
intestinal catarrh and irritability of the stomach was frequently present during these attacks.
After repeated attempts the B. Influenzae was at last isolated in pure culture from the fresh
expectoration and a course of autogenous B. Influenzæ vaccine was given. The result of this
treatment was most gratifying. There has been almost no attack of any severity since the
treatment was commenced and the general health has been steadily improving.
Two cases which have been included in this class deserve a short description as they
indicate the possibility of applying vaccine treatment with benefit to cases of secondary
infection in tuberculosis of the lungs.
Case 22.—One of mixed Pneumococcus and streptococcus infection in pulmonary phthisis.
The combined autogenous vaccine brought about considerable relief of the cough and reduc
-
tion of the expectoration with a marked improvement in the general condition of the patient.
As a direct effect of the treatment of the secondary infection the nocturnal sweats were
relieved, and the hectic fever was greatly reduced. The rapid progress made by the case
during the vaccine treatment left no doubt as to its decided value independent of the
medicinal, dietetic and hygienic measures.
Case 108—was one of fibroid phthisis in which Tuberculin B.E. was ill borne on account
of hyper-sensitiveness and severe reactions. There was a hectic temperature of 98.4°F—103°F.
The sputum showed large numbers of streptococci. A course of autogenous streptococcus
injections from 2½ to 15 million given during a period of three weeks brought the temperature
down to normal, the cough subsided, the night sweats stopped, the appetite got better, and
the general condition of the patient had so far improved that Tuberculin P.T.O. was soon
commenced and borne without reactions and with benefit.