14
Case 73.—One of chronic pharyngitis with extension of the inflammation to the nose,
Eustachian tube and middle ear and partial deafness. Whilst at home he had consulted a
number of ear specialists but has not yet benefited by any treatment. Cultivations from the
pharyngeal mucus gave a mixed growth of pneumococcus and Bacillus influenzæ. A
combined autogenous vaccine was made and injected in increasing doses. A distinct improve
-ment was soon noticed in the catarrhal condition of the throat and nose and the hearing has
slightly improved. The patient is still under treatment.
Case 12 was one of chronic recurring pharyngeal catarrh in a person of 41 years. The
cultivations were made in a station in Assam, where the patient was living and sent by post
to this laboratory, which they reached five days later. The pneumococcus was the predominant
organism and was made into a vaccine. After a series of six injections, the patient made an
apparently complete recovery. The interesting feature in this case is the ease with which the
pneumococcus, a delicate organism, grew in the culture tubes during the five days transit by
post at the ordinary temperature of the air.
TABLE VII.
Inflammations of the mouth, nose, throat, ear, and conjunctiva.
Serial
nu
m - b e r .
Case
num
-ber.
Medical Officer.
Disease.
Vaccine made.
Result.
1
1
. . .
Pharyngitis . . . Pneumococcus . . . Not known.
2
9
. . .
Naso-pharyngeal
catarrh.
Do. . . .
Do.
3
12 Dr. James Couway, Hoogrijan, Assam. Recurring pharyn-
gitis.
Do. . . . Cured.
4
35
Do.
do.
Pharyngitis . . .
Do. . . . No effect.
5
47 The Superintendent, Ophthalmic Hos-
pital, Egmore.
Conjunctivitis . . . Diphtheroid bacillus
and staphylococcus
albus.
No improve
-ment.
6
59
. . .
Pharyngitis . . . M. Catarrhalis and
pneumococcus.
Not known
7
73
. . .
Chronic sore throat
otitis media and
pharyngitis.
Pneumococcus and
Bacillus influenzæ.
Improved.
8
85 The Superintendent, Ophthalmic Hos-
pital, Egmore.
Conjunctivitis . . . Streptococcus . . . Not used.
9
93 The Assistant Surgeon, St. Bartholo-
mew's Hospital, Ootacamund.
Stomatitis
. . .
Do. . . . No effect.
10
98
. . .
Pharyngitis . . .
Pneumococcus . . . Not known.
Asthma, bronchitis and lung af f ections.—Of the 23 cases of asthma and chronic bronchitis
for whom autogennus vaccines were made, the result is known in 13 cases only. In the
remainiug 11 either the result was not reported or the vaccine could not be administered or
the treatment is not yet complete. Nine of the 13 cases were improved by the treatment, five
of these being reported greatly improved. It is interesting to note that in these five cases, the
pneumococcus either alone or with the B. influenzæ was the organism isolated from the
sputum. This confirms the experience of previous years, that the pneumococcus is the most
frequent cause of catarrhal inflammation of the bronchial mucous membrane.
Another point worth mentioning in connection with the dosage of these bronchitis
vaccines is that in the majority of cases the smaller doses of 2½, 5 and 10 million which were
used formerly were found to be of no real value and that to save time and prevent disappoint
- m e n t t o p a t i e n t s , i t i s b e t t e r t o b e g i n w i t h h i g h e r d o s e s a n d i n c r e a s e t h e m r a p i d l y u p t o t h e
optimum limit as judged by the first sign of definite improvement and thenceforth increase
the doses slowly and cautiously. Thus in the great number of cases, 10, 20, 50, 75 and 100
million pneumococci could be injected in succession at intervals of four to six days and the
large doses of 150, 200, 300, 400, 500 or more, could be administered at intervals varying from
one to two weeks, depending on the progress of the case. In this way a dose of 1,000 million
of pneumococci, B. influenzæ or M. Catarrhalis could, safely and with marked benefit, be
reached, and such maximum doses repeated at long intervals, say once a month or so, until
such time that the patient has completely got over his catarrhal trouble. The following case
is an illustration of the inefficacy of small doses
: —
Case 69.—A young man of 37 years suffering for five months from an attack of bro
n - c h i t i s w h i c h b e g a n w i t h a c u t e f e b r i l e s y m p t o m s a n d s o o n l a p s e d i n t o t h e a s t h m a t i c t y p e .
Cultivations from the sputum showed mixed infection with pneumococci and B. influenzæ.