270 PUBLIC HEALTH BACTERIOLOGY 



the sputum. He had often noted mixed infections, and a 

 Gram-negative bi-polar-staining bacillus was seen at times, 

 which was not the plague bacillus. It required further 

 study. Involution forms bore no relation to virulence. 

 Blood cultures could usually be got forty-eight hours 

 before death. At least i c.c. of blood must be used for 

 the test. In this way an earlier diagnosis could be made 

 than by the sputum. In recovered bubonic cases, agglu- 

 tination could be got in the second and third weeks with 

 dilutions of 1-25 and 1-50. Agglutination and fixation 

 of the complement experiments were of little value in 

 pneumonic plague. Dr. Broquet advised the use of the 

 following solution for the conservation of suspicious 

 plague organs for future study or transmission to a 

 laboratory at a distance : neutral glycerin, 20 c.c., 

 calcium carbonate, 2 grm., distilled water, 80 c.c. Mix at 

 30 C., and immerse tissues. 



Vaccination. Protective vaccination with attenuated 

 plague bacilli was advocated by Dr. Strong. Professor 

 Galeotti advised the vaccine of Lustig and Galeotti for 

 these reasons : (i) The toxin (Galeotti holds that it is an 

 endotoxin and non-soluble ; Zabolotny holds that it is a 

 soluble toxin), and no other substance, is used ; (2) It can 

 be dried and standardized ; (3) The plague nucleo-proteid 

 can be stored in a sterile condition. The general experience 

 was that no form of vaccination gave much protection 

 against pneumonic plague. 



Serum Therapy. Dr. Martini advised passive immuniza- 

 tion for all those exposed to infection, such as doctors and 

 nurses, etc. Small doses were useless ; 100 c.c. at least 

 must be used, and repeated soon. As regarded the present 

 epidemic, he thought the protective value was small. 

 Professor Zabolotny reported that he had used up to 

 i litre of serum without success, only prolonging the illness. 

 Dr. Paul Haffkine had seen protective effect after large 

 doses, but this did not last more than five days. 



Quarantine. The use of railway cars for this purpose 

 was a new feature. This gives a segregation camp divided 

 into small units, each completely isolated from the other, 

 easy of disinfection, easy to supervise and for the detection 

 of onset of sickness. There were 3000 suspects thus 



