Nelles Silverthorne

The treatment of meningitis due to hemolytic streptococcus with sulfanilamide

Summary 1. From 1924 to 1936, ninety-three patients suffering from meningitisdue to hemolytic streptococcus have been admitted to hospital. These patients were treated by one of the following procedures, or by a combination of them: namely, spinal drainage, intravenous glucose-saline injections, scarlet fever antitoxin, and mastoidectomy when indicated. In this group there was only one recovery. 2. Nine patients with streptococcic meningitis during 1937 have been treated with sulfanilamide, a continuous intravenous injection of glucosesaline and daily spinal puncture with drainage. Mastoidectomy was performed in six of the nine patients in whom mastoiditis was present. Five of these nine patients have recovered. 3. It is our belief that sulfanilamide has been chiefly responsible forthe satisfactory outcome in our patients suffering from streptococcic meningitis secondary to mastoid disease.

Whooping cough: II. Preliminary report on the use of immune rabbit serum inimmediate protection of contacts against whooping cough

Summary A preliminary study on the use of immune rabbit serum in the preventionof whooping cough after immediate contact with the disease suggests that such a serum may be valuable in the prevention of this disease.

Diagnostic methods in whooping cough

Summary 1. Direct smear of nasal mucus has revealed gram-negative bacilli in 80 per cent of patients with known whooping cough as compared to 12 per cent in cases not suffering from whooping cough. 2. Cough plate cultures (taken in triplicate) were positive for Hemophilus pertussis in 55 per cent of instances compared to cultures of nasal mucus which were positive in 42 per cent of the cases. 3. Both culture methods used simultaneously were found to be superior in isolating Hemophilus pertussis to either one alone. In conclusion, it is felt that direct smears of nasal mucus in the early stage of whooping cough are helpful but not infallible in obtaining preliminary evidence in the diagnosis of the disease. With our technique cough plate cultures (taken in triplicate) are superior to nasal mucus cultures in isolating Hemophilus pertussis from patients with whooping cough at any age up to 14 years.

Whooping cough: III. “Pertussis toxic material” and the effects of antigensin animals

Summary Our experiments with “pertussis toxic material” confirm in the mainthe work of Evans and Maitland. There is no laboratory evidence from our experiments in animals that “toxic materials” are preferable to vaccine made from the whole microorganism for use in human immunization.

Whooping cough: I. Vaccine and serum protection experiments

Summary A brief review of the literature dealing with various investigations onwhooping cough has been made. Pertussis vaccines prepared by different methods have been tested fortheir protective effect against a fatal septicemia in mice. It has been shown that phenolized pertussis vaccine and boiled vaccine in small amounts (0.3 c.c.) protect mice against a fatal septicemia. Agglutinins and mouse protecting antibodies have been demonstrated in the blood serum of children vaccinated with fresh strain pertussis vaccines. No prepicitins have been found, and bactericidal substances are questionably present. A satisfactory mouse protection test has been developed for use in testing both the antigenicity of vaccines and the protective power of serum.

Studies on meningococcus infection

Summary In this report we have attempted to review some of the aspects ofmeningococcus infection which may have a very definite bearing on the evaluation of treatment. The points to be considered are variations in clinical type, variations in prognosis with the same clinical type, variations in virulence and type of infecting strains, the mechanism of immunity response in patients, and finally, the treatment instigated. All these aspects of the disease should be properly evaluated before too many far-reaching claims are made solely on the basis of newer methods of treatment.

Cutaneous myiasis in infants

Case reports. Case 1.-K. E., a male, aged three weeks, was admitted on June 9, 1934, and discharged on June 20, 1934. CONIPLAINT. Rash on arm and neck for one day. HISTORY OF PRESENT ILLNESS. The infant was quite well until the day of admission, when spots appeared on the arms and neck. The baby had been sleeping out of doors. PHYSICAI, EXANIINATION revealed a well-develoned and well-nourished male infant who was not acutely ill. The cutaneous system showed the presence of what appeared on first examination to be several scattered pustules on the right arm and on the right side of the neck. From the area on the right side of the neck a small maggot was removed with forceps. A definite small purulent sinus was left, surrounded by a red, indurated margin. This sinus in the side of the neck is shown in fig. 1.

Whooping cough: IV. Beef liver extract blood agar media for growth ofH. pertussis

Summary Beef liver extract agar with added citrated sheeps blood supports the growth of phase I pertussis. After repeated subculture this medium preserves the phase I characteristicsof H. pertussis.