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together up to the time of treatment with serum); after exposure to the serum the S. cholera grew readily, while B. lepræ failed to show any growth when planted on glycerin agar.

It is only fair to state here that we did not consider it at all probable that this horse had been immunized long enough to possibly produce a curative serum, but when we secured this evidence of agglutinin production we felt justified in temporarily discontinuing the injection of the animal in order that we might obtain a quantity of its serum and employ it on our patients. After obtaining a quantity of this animal's serum for our purposes we again resumed our attempts to immunize it, and are still carrying on these injections of our horse in hopes of obtaining a more potent serum.

ANIMAL EXPERIMENTS WITH THE ABOVE-MENTIONED SUBSTANCES.

We injected ordinary laboratory animals with all of the abovementioned substances in order to first ascertain whether they were free from pathogenic extrageneous organisms, and also to note any physiological effect that these substances might produce. A number of animals were used in these tests, but for sake of brevity we will summarize the effects noted with each substance employed.

The vaccine caused the same local effect on rabbits, guinea pigs, and rats, namely, an area of coagulation necrosis at the site of injection, followed either by absorption or abscess formation, depending on the dose and strength of the vaccine given. There was no general effect appreciable.

The live cultures usually caused nodules at the site of injection, accompanied by about the same pathological changes as were noted when the killed cultures (vaccine) were given. It was thought that the animals receiving the live cultures showed more evidence of a general effect than when the vaccine was employed, but this was only in a general way, and most of the animals appeared unaffected by the injection. One guinea pig died, apparently as a result of placing a loopful of live cultures, recently isolated from a leper, under the animal's skin, and some of the other animals were made ill. The "lepratoxine" that did not contain ground bacilli caused neither local nor general effects in the animals inoculated with it. The "lepratoxine" which contained ground bacilli produced a slight local reaction at the site of injection, but in the few experiments tried it did not cause abscesses, as the unground vaccine had.

The fatty extract, obtained by the use of chloroform and alcohol, when given in large doses, caused an abscess to form at the site of inoculation, without any appreciable general disturbances.

The "sensitized "killed cultures of the lepra bacilli caused neither general nor local effects, even when injected into the peritoneal cavity.

This absence of local effects may have been due to the fact that the suspension contained a much fewer number of organisms per cubic centimeter than our vaccine did.

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The horse's serum was without any appreciable effect on the animals that received it.

THE USE OF THESE SUBSTANCES ON THE PATIENTS UNDER OUR CARE.

Owing to the fact that the number of our patients was limited, we had in most instances to employ one of the above substances for a time, and then, after abandoning its use, employ another one of our substances on the same patient. As none of the substances employed, however, have apparently been of much if any benefit to the patients receiving it, we do not consider this to be a serious flaw in the data that we have to present. Inasmuch, however, as a single patient received more than one substance, it will be convenient to give a history in tabular form of each of the patients treated, and in this table to include the data on the use of the substances which we are discussing.

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42 days.. Following the 2d, 3d, 4th, and 5th injections.

Abscess following the
6th, 7th, 8th, and 9th.
121 days. All caused local reactions
except 4th, 5th, 7th,
9th, and 10th; 20th and
21st causing abscess.

49 days.. Following the 6th, 7th
(abscess), 8th (ab-
scess), and 9th (ab-
scess) injections.

100 days. Following the 12th (ab-
scess), 13th (abscess),
14th, 15th, 16th, and
17th (abscess) injec-
tions.

62 days.. Following the first injec-
tion.

49 days.. Following the 4th, 5th,
6th (abscess), 7th (ab-
scess), 8th (abscess),
and 9th (abscess).

1

7 days...

Remarks.

Following the 5th in- Erythematous induration jection.

Following the 17th,
21st, 22d, and 23d
injections.

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Hyperemia increased on
buttocks, ulceration of
the septum healed.
Acid-fast bacilli disap-
peared from the nose.

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20 Female.. 12 Nodular 4 years.. Lepratoxine. Initial, 0.01 c. c. to

leprosy.

2 c. c.

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16

163 days. Following the 4th, 5th,
7th, 14th (abscess),
17th, 18th 19th, 20th
(abscess), 22d (ab-
scess), 24th, and 25th
injections.

261 days. Following the 2d, 3d (ab-
scess), 4th, 8th, 11th,
12th (abscess), 13th
(abscess), and 15th in-
Jections.

16 253 days. Following the 3d, 4th, 9th, 11th, and 12th (abscess), 13th, 15th, and 16th injections.

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Nodular 5 years.. Lepratoxine. Initial, 0.04 c. c., in

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Jeprosy.

creasing to 2 c. c.

260 days. Following the 3d, 4th, 10th, 12th, 18th, 19th, and all injections from 22d to 30th, inclusive; 31st injection (abscess).

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leprosy.

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14 59 days.. Following the 14th injec- Following the 4th

tion.

10 133 days.

(frontal headache) and 12th injections.

Hyperemia and infiltration
of the face increased.

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2d infection, 1/3 oese. 3d injection, 2/5 oese.

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