xlix
following such operations is due to a subsequent infection. Thus in case 113 the patient was
progressing well till the fifth day after the operation, when he had a rigor followed by a rise of
temperature and attended with a profuse and unhealthy looking discharge. Complete recovery
followed the injection of two doses of autogenous coli vaccine 10 and 20 millions respectively.
Case 95 —Liver abscess in an alcoholic subject.— About 30 ounces of pus removed by
operation. Temperature was high on the tenth day after operation and the discharge was
profuse. Four doses of autogenous coli vaccine (10, 20, 50 and 100 millions) were administered
at intervals of three days. The temperature went down steadily with each succeeding injection,
the discharge lessened and the abscess cavity rapidly filled up, the patient being discharged from
the hospital as cured in less than a month from the commencement of vaccine treatment
Appendicitis.— Three cases of this disease were placed under vaccine treatment during the
year, of which two were cured and one was reported as improved. As can be seen from the short
notes of the following two cases, it is not meant that the cases of appendicitis as such were
cured by vaccine therapy without surgical interference. The treatment was really applied to
the post operation condition wherein after removal of the appendix or drainage of the appendical
abscess there still remained or followed an infection of some part of the area operated on.
This might be the abdominal wall, the gut itself or the perityphlitic connective tissue and
resulted in delayed healing and septic absorption. The vaccine treatment was merely directed
towards the removal of the secondary infection, which was an obstacle to the healing process.
The B. Pyocyaneus was isolated from one case, a B. Coli from a second. and the staphy-
lococcus aureus from the third. The results were good.
Case 16.—Suppurative appendicitis in a young woman of 28 years. On opening the
abdomen a large abscess was found on the inner side of the caecum. The appendix could not
be seen and a dramage tube was inserted. For a week after the operation the discharge conti--
nued and the temperature kept up. Autogenous B. Pyocyneous vaccine, 50 million, was
given and in three days the temperature dropped down to 99°F. A second dose of 70 million
was then administered and a third one of 100 million a week later. The temperature came
down to normal and the discharge almost ceased enabling a successful o peration for appendicec--
tomy to be performed.
Case 25.—Septic trouble at seat of operation for appendicitis about three weeks after the
operation, the temperature ranging between 100°F and 1 02.4ºF. With each succeeding dose of
autogenous coli vaccine the temperature went down and the discharge lessened, the wound
healing completely after the third. and highest dose of 100 million bacilli.
Dysentery and Colitis.—Six samples of dysenteric stools were received for bacteriological
examination. The B. Dysenteriae was isolated from four of these, two of the strains being of
the Shiga type and two of the Flexner type. One of the cases was dealt with successfully by
autogenous vaccine treatment. The others were treated medicinally or by stock vaccine.
A case of chronic colitis of five years' duration was treated with a vaccine of B. Coscoroba
which was found to predominate in the cultures made from the stools, with the result that a
marked improvement was reported.
Stock antidysenteric vaccine was used on a small scale in the Kilpauk Lunatic Asylum and
in the General Hospital as a curative during the acute stage of dysentery. The results seem to
have been encouraging.
Asthma and Chronic Bronchitis.—of the 12 cases of chronic bronchitis six were pneumococcal
and six apparently streptococcal. Of the 12 cases of asthma, four were pneumococcal and in eight
streptococci only were grown.
In four out of the six cases of chronic bronchitis with asthma which improved the
organism isolated was the pnemococcus. This organism was found to be a very delicate
one as regards its capability of growing and surviving in artificial media. Unless the fresh
sputum was planted out on serum media immediately it was expectorated and the culture tubes.
incubated at once at blood heat, it was mostly found impossible to grow this diplococcus.
This probably explains why in such a large number of cases of chronic bronchitis (6 out of
12) and asthma (8 out of 12) the organism isolated was streptococcus, in most cases a
purely adventitious organism, such as is normally present in the mouth and throat. It pro--
bably also exists in the chronically inflammed mucous membrane of the trachea and the larger
tubes, characteristic of these diseases. Unlike the pneumococcus of acute lobar pneumonia the
organism of chronic bronchitis and asthma was mostly non-pathogenic to rabbits, though in its
cultural and biological characters it was more or less identical with the former. Two types of
pneumococcus could be distinguished in the different strains isolated. One of these grew in
absolutely transparent dewdrop colonies of small size which after 48 hours became granular and
ultimately tended to break up into an almost invisible film on the surface of the serum agar.
The other and less common variety was slightly opague, gave a more exuberant, thick and
gelatinous growth. The colonies grew rapidly to a large size and coalesced to form patches
with irregular wavy margins. Both varieties fermented inulin and were found to be possessed
of poor viability in artificial media. They very often died. out after a few sub-passages.
13