1919 .] 
New Zealand Institute Science Congress. 
255 
tenacious as noted in some of the pneumonia patients. The appearance of the patient 
and the characteristic naked-eye features of the sputum always strongly suggested the 
nature of the illness. 
From the notes he had detailed complications were found to be due to three 
bacterial groups: (1) Pneumococcal, including a diplococcus not definitely identified; 
(2) streptococcus; (3) staphylococcus. 
Reports on the examination of white blood-cells in all the statistics he had seen 
agreed very closely. The true influenza, without any complications, exerted little 
effect on the blood, and frequently the white cells were diminished. Even when the 
severe complications had occurred, the white cells did not show the great increase one 
would expect. A big increase in the white cells was looked upon as a good sign in an 
acute illness of bacterial origin—that was, say, an increase up to twenty-five thousand. 
It indicated that the blood-cells were putting up a good fight. On the other hand, a 
high percentage of polymorph cells was looked upon as indicating a severe toxaemia. 
The average count of white blood-cells in the influenza cases was either normal or 
below normal, while the polymorph cells were decreased. 
Experiments in vitro had proved that bacteria exert an attractive influence over 
the blood, but the blood counts in true influenza would suggest that attraction 
occurred in living tissues, but the bacteria were not ingested. It would seem that the 
poisons had a repellant effect on the blood. If that was the case, they would expect 
that the individual powers of resistance against other bacterial groups during the time 
that the influenza poisons were in the body were much lowered, and, in view of the 
different bacteria found causing complications, that seemed to be true. Not only 
could the other bacteria gain entrance during that period, but when they had started 
infection the depressant influence primarily caused by the influenza still continued to 
a large extent, so that the bacteria which were setting up the complications did not 
meet with the usual resistance from the white cells and blood fluid, and consequently 
become masters of the situation. On the same reasoning he thought it possible to 
explain the considerable varieties of bacteria causing the complications. 
They knew that bacteria were found in the throats of even healthy people, and 
that with unhealthy conditions of the mouth, such as were associated with decayed 
teeth and inflamed gums, bacteria were very profuse. The bacteria were of many 
groups, but they included the streptococcal, pneumococcal, and stephylococcal groups 
even in the healthy individual. They were, however, kept in check by the normal 
resistance of the body. Further, they would expect the individual with the unhealthy 
mouth would be more liable to complications than the normal person. This, he thought, 
was undoubtedly the case in the recent epidemic : perhaps it would be safe to say that 
people with septic conditions already present in the mouth and throat were more liable 
to severe complications than people with healthy condition of the mouth and throat. 
Of course, they must also realize the fact that the influenza patient when he inhaled 
the influenza bacilli might have inhaled at the same time pneumococci or other bacteria 
whose virulence had already been increased in the first influenza patient. Again, a 
person in close contact with a pneumonic patient might inhale the bacteria causing the 
complication only, and become a victim of pneumonia or blood-poisoning without a 
primary attack of influenza. 
The possibility of a new organism as the cause of the pandemic must be con¬ 
sidered. Roux, in a recent communication to the Academy of Sciences, Paris, 
announced that a filterable virus had been obtained from the expectoration of influenza 
patients, and that that filtrate had produced the typical symptoms of influenza when 
inoculated into monkeys. In a brief cable in that day’s newspaper an announcement 
of a somewhat similar nature was made by the R.A.M.C. If that proved to be true 
they might have an accentuated case of symbiosis of that new organism with the 
influenza bacillus, for there was no doubt that the influenza bacillus had played a very 
prominent part in the present pandemic. 
He wished to say a few words on the possible use of vaccines in that great pan¬ 
demic. The vaccine was first used on the 19th November, it having taken three days 
to prepare a sufficient quantity, and from the 19th November nearly all patients with 
pneumonic complications received daily doses of the vaccine. In all 238 patients 
received the vaccine, and of those ninety-one died, while of seventy-five patients 
admitted from the 19th November with pneumonia complications who did not receive 
vaccine forty-one died. He thought the opinion of the medical and nursing staff was 
in favour of the vaccine. He was convinced from his own observations that it did 
not do any harm, and even if it was the means df saving only a dozen lives it was 
worth using. As a preventive measure vaccines had been highly successful. 
In Christchurch the vaccine was not used as a preventive. When used in that 
way it had been the custom to give two injections with an interval of ten days between 
