100 CLINICAL BACTERIOLOGY AND r 



ascertain what causative organisms are present by adopting 

 the usual technique. The Staphylococcus albus and aureus 

 combined we have found in our three last cases. We 

 are at present treating a case where we detected these two 

 bacteria, and in addition a rather uncommon bacterium — 

 i.e., B. pyocyaneus (belonging to the chromogenic class) . 



In this disease, one has to give full vaccine doses if the 

 best results are to be obtained. The writer usually starts 

 with 750,000,000 Stajriiylococcus aureus and albus, and in 

 this latter case combined it with 250,000,000 B. pyocyaneus, 

 the doses being doubled each time. 



The patient has had up to the present three injections, 

 and progress so far is quite satisfactory : the swelling is 

 becoming smaller and softer, and the stiffness has dis- 

 appeared. During the negative phase this increased, how- 

 ever, and for twenty-four hours the animal scarcely walked 

 at all, being very stiff on his front-legs. Locally there is one 

 central sinus, which discharges intermittently. The sinus 

 has been curetted and irrigated with soda citrate solution 

 alternated by normal saline solution. Since these notes 

 were made, this case has completely recovered and been in 

 constant work for six months. 



Fistula in the Region of the Anus and Rectum. 



This condition in equines is seen often as a sequel to 

 strangles running an irregular course, and is most intractable 

 to the ordinary forms of treatment. If the case is one 

 of long standing, the immunizer usually finds the purulent 

 discharge contains more than one bacterium. Strepto- 

 cocci there usually are, staphylococci there may be, and, 

 considering the situation, one has every justification in 

 being on the careful lookout for B. coli communis ; and if 

 present a suitable vaccine should be made. In human 

 vaccine-therapy, we understand, a stock vaccine of the 

 B. coli acts very well. 



The writer recalls treating a case with staphylococcal and 

 streptococcal vaccine, giving extremely large doses and fail- 



