500 BIOLOGY OF PNEUMOCOCCUS 



mixed vaccine showed decreased pneumonia mortality. A fair criti- 

 cism of the work of both Ordman and Orenstein would be the in- 

 completeness of their studies of the natural bacterial flora of the 

 natives both in the population at large and among the workers be- 

 fore and after prophylactic vaccination. Furthermore, as is the 

 case in practically all studies of mass vaccination, the communica- 

 tions include no observations on the production of specific anti- 

 bodies in the vaccinated subjects.* 



Less discouraging was the experience of Peall (1935). 1075 Dur- 

 ing a three and one-half year period, over 68,000 native workers in 

 the Randfontein mines were given, at weekly intervals, three doses 

 of a mixed vaccine containing pneumococci — the "community au- 

 togenous vaccine" — and there occurred a prompt and marked 

 drop amounting to 70 to 80 per cent in the incidence and fatality- 

 rates of pneumonia and of other respiratory infections as well. 

 Despite previous doubts, Ordman 1034 resumed his endeavors toward 

 the prevention of pneumonia and other respiratory disease, and 

 this time among a presumably highly susceptible class of natives — 

 workers who had been prohibited by the South African government 

 from working in the Rand gold fields because of the extremely high 

 pneumonia rates prevailing among them. Previous to prophylactic 

 vaccination, the annual attack-rate was from fifty to eighty per 

 thousand and the mortality-rate eighteen to twenty per thousand. 

 After the continued use of a mixed vaccine containing only one 

 type (Type II or Group B) of Pneumococcus combined with two 

 varieties of streptococci, Micrococcus catarrhalis and Staphylo- 

 coccus aureus, administered in three weekly doses, the fatality-rate 

 from pneumonia fell from 13.9 to 2.4* per thousand — a reduction 

 of 82.7 per cent. 



A recent historical review, summarizing the preventive work 

 done in the Rand and neighboring mines and reporting the latest 

 experience of the authors, was published in 1935 by Lister and 



* For a general review of the many phases of the use of vaccines in warding 

 off pneumococcal infections or in their cure, the reader is referred to Park's 

 third Harben Lecture.iose 



