296 DISEASE CONTROL 



out of 67 cases) and otitis media (7 immediate recoveries out of 8 

 cases). In pulmonary infections (44 cases), recovery or improvement 

 was obtained in 61 per cent j streptomycin is extremely effective against 

 acute Friedlander bacillus infections. No dramatic effects were seen in 

 acute brucellosis (45 cases). In typhoid (51 cases), streptomycin, if 

 given early, accelerated return of temperature to normal. Of 26 cases 

 with Salmonella infection, 12 recovered, 8 died. Encouraging results 

 were obtained in peritonitis (39 recoveries out of 53 cases). 



Preliminary evaluation of streptomycin in tuberculosis was based on 

 75 cases. The results that have been observed in miliary tuberculosis, 

 in tuberculosis of the meninges, and in tuberculosis of the larynx, skin, 

 and renal tract were considered as highly suggestive that streptomycin 

 exerts a bacteriostatic effect on the growth of the tubercle bacillus in 

 man. The same can be said for exudative pulmonary tuberculosis. It 

 was recommended that a minimum period of treatment should be three 

 to six months with doses of 1.5 to 3.0 gm. a day. The over-all incidence 

 of untoward side effects was 20.5 per cent. The commonest reactions in 

 order of frequency were headache, fever, skin eruptions, flushing of the 

 skin, and vertigo, alone or in various combinations. 



For the treatment of tubercular meningitis, intrathecal administra- 

 tion of 100 mg. daily has given encouraging results, especially when 

 combined with parenteral administration (152a). 



Failures of streptomycin therapy were attributed to the following 

 factors: treatment of infections not susceptible to streptomycin 5 inade- 

 quate dosage J development of resistance to streptomycin in vivo; 

 change in the species of infecting organism during treatment j and 

 localization of infection in an inaccessible area. In view of the develop- 

 ment of resistance of bacteria to streptomycin, as can easily be demon- 

 strated in urinary tract infections, it was recommended (511a) that 

 high Initial doses be used. 



Other Agents 



The protective action of the specific enzyme (polysaccharidase) of a 

 soil bacterium against type III pneumococcus infection has also been 

 established (31a). The specific protection induced in experimental 

 animals is determined by the nature of the polysaccharide of the pneu- 



