294 DISEASE CONTROL 



in 15 minutes with a decrease to 4.9 ng in six hours. Following a 

 similar intramuscular injection, the rise was slower, with 26.5 pg at 3 

 hours and 8 pg at 6 hours per ml. of blood. The recovery of the strep- 

 tomycin in the urine varied during the first 24 hours, between 29 and 

 89 per cent, with an average of 66 per cent. 



In the treatment of chronic infections of the urinary tract in man, 

 streptomycin was found to be effective in destroying such gram-nega- 

 tive bacteria as P. vulgaris, A. aero genes, E. coli, Ps. aeruginosa, and 

 Eberthella sp. Four hours after commencement of streptomycin 

 therapy ( i gm. of streptomycin daily in 8 divided doses given intra- 

 muscularly), urinary cultures were negative for P. vulgaris and, after 8 

 hours, for coliform organisms. In one case, the urine became negative 

 for E. coli two hours after treatment. Though infections of the normal 

 urinary tract were permanently cleared up, reinfection was likely to 

 occur in damaged tracts, the catheter serving as the portal of entry for 

 the new infection. 



Streptomycin has also proved effective for the treatment of enteric 

 and systemic diseases. In five severe to moderately severe cases of 

 typhoid studied by Reimann (772), streptomycin was not administered 

 until late in the development of the disease. Nevertheless, the clinical 

 improvement of three patients coincided with the period of strepto- 

 mycin therapy. Of the two unsuccessful cases, the treatment of one was 

 prematurely discontinued because of the limited quantity of strepto- 

 mycin available. 



In a study of 45 patients suffering from a variety of infections, it was 

 found (414) that good results were obtained in 10 of 13 cases of 

 moderately severe and severe infections of the urinary tract due to 

 various pathogenic bacteria. Of 5 cases of infection involving the tra- 

 cheobronchial tree, satisfactory results were obtained in 4. In some 

 miscellaneous infections, comprising cases of typhoid fever, undulant 

 fever, osteomyelitis, cellulitis, peritonitis, cholangitis, meningitis, and 

 ozena, the results could be considered satisfactory. Of 8 cases of bacteri- 

 emia, 6 showed recovery. Doubtful results were obtained in 2 cases of 

 undulant fever associated with bacteriemia. In 4 cases of syphilis it was 

 doubtful whether treatment with streptomycin was effective, although 



