WILLIAM PALMER LUCAS, M. D v AND HAROLD L. AMOSS, M. D. 247 



of 25 cases. In only one or two of these cases was the presence 

 of the B. dysenteriae suspected at the time the culture was taken 

 and in the case which died the final acute attack was very short 

 and severe. This is interesting when compared with the type 

 of the acute attack in the three cases that developed acute in- 

 fectious diarrhoea later in the summer, in which the infection 

 took the sub-acute form. 



AGGLUTINATION 



Agglutinations were done in 36 of the 95 vaccinated cases. 

 The agglutinations ranged from negative at 1 to 50 in some of 

 the vaccinated cases to positive at 1 to 400 in several of the 

 cases. No difference was noted in the agglutinating power of 

 the 6 cases in which the dysentery bacillus was isolated. A few 

 control agglutinations were taken from some of the cultured 

 cases in which the dysentery bacillus was found but which were 

 not given the vaccine. One of these cases agglutinated very 

 strongly up to 1 to 100, another only mildly at 1 to 100 and a 

 third only mildly at 1 to 50. Several control cases which were 

 culturally negative, gave negative agglutination reactions. One 

 case which was neither vaccinated nor cultured and which was 

 clinically not one of infectious diarrhoea gave a strong agglutina- 

 tion at 1 to 100. 



The home conditions of all the vaccinated cases were studied 

 and recorded. There can be no question that whatever the treat- 

 ment outlined at a clinic may be, nor what preventive measures 

 are instituted, they are more or less of no avail in the unsanitary 

 conditions under which a fair majority of these children were 

 compelled to exist. The question of the presence of flies ap- 

 peared to be a most important one and toward the end of the 

 summer an attempt was made to discover how far the fly en- 

 tered into the carrying of the dysentery infection. To this end 

 sterilized fly traps were placed in several of the homes of cases 

 from which the dysentery bacilli had been recovered. In two 

 out of three such attempts the dysentery organism was recovered 

 from an emulsion made from these flies. The manner of pro- 

 cedure was as follows: An ordinary wire fly trap, sterilized by 

 heat, was left at the house for two or three days. The traps 

 when brought to the laboratory were set in a cold room (4 C.) 

 for 15 minutes. The cold numbed the flies to such an extent 

 that they could be picked out of the cage with sterile forceps 

 and placed in broth. The drowned flies were ground in sterile 

 mortar and plates made from the emulsion a part of which was 

 plated on Hndo's medium. Any suspicious colonies were run 

 through the ordinary media for isolating the dysentery organism, 

 and finally tested for agglutination. In these two cases in which 



