The Nature of Pneumonia and the Serum Treatment

COLE
1917 American Journal of the Medical Sciences  
1917, cv, 233 ) from a study of pneumonia at the Rockefeller Institute, reports that most cases of pneumonia are caused by pneumococci which can be divided into at least four-types. Over 500 cases of pneumonia have been studied for the purpose of deter¬ mining the relative frequency of the different types of infection. The results showed that 60 to 65 per cent, of all cases were due to pneu¬ mococci of Types I and II, while 10 to 15 per cent, were due to pneu¬ mococci of Type III, the remaining
more » ... III, the remaining 25 per cent being due to pneumo¬ cocci belonging to Type IV. Studies were also made to determine the frequency of occurrence of the different types in 'mouths of normal persons. In examinations of 527 people, 254, or about half, showed pneumococci. They belonged to the Type IV group in 75 per cent. In 17 per cent, the pneumococci were of the Type III group, while in less than 12 per cent, they were of the so-called fixed Types I and II. In practically all the instances in which organisms of Types I and II were found in normal mouths, it was possible to trace a close relation¬ ship between these individuals and a case of pneumonia of the same type. Pneumococci of Types I and II tend to disappear from the mouth in a short time as after convalescence from pneumonia. The author believes that isolation of cases of pneumococci of Types I and II should be more strictly observed than is the usual practice. With the present knowledge it was not possible to have an opinion on the value of isolation of cases due to pneumococci of Type III. Probably no effect would be obtained by isolation in cases of infection with Type IV. With regard to specific treatment the author believes that vaccine treatment is without much beneficial effect. He has made use of serum prepared from animals made immune to organisms of the different types. He notes that on account of the specificity of types it is neces¬ sary to determine the type of infecting organism in eadi case before instituting serum therapy. This determination-of type of organism is of important prognostic value. The author has used immune horse serum prepared against the three-important Types I, II, and III. The serum against pneumococci of Type I was of high power, that of Type II was considerably less powerful while that of Type HI had very little effect, either in the test-tube or on experimental animals. So far no attempts have been made .to use the serum on patients with Type III infection.. A limited trial has been made with serum against pneumococci of Type II, but the results have not been promising. The use of immune serum against infection with organisms of Type I, however, has given very gratifying results and experience indicated that with proper
doi:10.1097/00000441-191705000-00031 fatcat:lg6cjafaove63dj2a5r5pj242y