Am.  Jour.  Pharm. 
Nov.,  1918. 
Biological  Products. 
763 
all  three  organisms  and  affords  protection  against  them.  Even  in- 
cluding those  cases  where  the  men  go  to  camp  with  the  typhoid 
bacillus  incubating  in  them — in  every  100,000  there  must  always  be 
some  such  "  carriers  " — the  deaths  to  date  in  this  war  from  typhoid 
number  only  eight,  while  as  yet  there  has  been  no  case  whatever  of 
ill  effects  resulting  from  the  inoculation  itself.  In  the  French  Army 
the  monthly  typhoid  mortality  is  now  less  than  three  per  million. 
It  is  obvious  that  if  every  person  outside  of  the  army  could  be 
induced  to  submit  to  the  same  prophylactic  vaccination  against 
typhoid,  the  disease  would  just  as  quickly  disappear  from  civil  life. 
Pneumonia. — Health  reports  from  army  camps  and  civilian  com- 
munities during  the  past  winter  have  made  us  realize  the  seriousness 
of  the  pneumonia  menace.  It  has  been  known  for  some  time  that 
lobar  pneumonia  is  caused  by  the  pneumococcus,  but  serum  treat- 
ment was  in  many  cases  a  failure.  This  led  to  investigations  which 
showed  that  there  are  various  types  of  pneumococci  and  that  serum 
effective  against  any  one  type  is  not  effective  against  another.  Re- 
searches at  the  Rockefeller  Institute  disclosed  the  fact  that  there 
are  three  fixed  types  of  pneumococci  and  a  fourth  group  of  mis- 
cellaneous types.  These  have  been  named  Type  I,  Type  II,  Type 
III  and  Type  IV.  The  different  types  can  be  distinguised  from  one 
another  by  means  of  bacteriological  tests,  and  it  has  been  shown 
that  Type  I  is  responsible  for  about  33  per  cent,  of  all  cases  of  lobar 
pneumonia  and  that  the  mortality  from  this  type,  when  serum  treat- 
ment is  not  used,  is  about  25  per  cent.  About  31  per  cent,  of  cases 
are  due  to  Type  II  pneumococcus,  the  mortality  rate  being  32  per 
cent,  without  serum  treatment;  12  per  cent,  of  cases  are  caused  by 
Type  III  pneumococcus,  the  mortality  rate  being  estimated  at  45 
per  cent.  The  fourth  group  of  miscellaneous  pneumococci  causes 
about  24  per  cent,  of  all  cases  of  pneumonia,  the  mortality  rate,  16 
per  cent,  being  the  lowest  of  all. 
Experiments  have  shown  that  pneumonia  due  to  Type  I  pneu- 
mococcus is  amenable  to  serum  treatment.  Thus  far  pneumonia 
due  to  Type  II  and  Type  III  has  not  responded  very  favorably  to 
serum  treatment  and  there  has  been  no  success  with  serum  in  cases 
of  pneumonia  due  to  any  of  the  pneumococci  in  group  IV.  When 
it  is  possible,  through  bacteriological  examination,  to  determine  the 
type  of  the  infecting  organism,  it  is  desirable  to  use  the  serums 
specific  for  that  type.  However,  many  practitioners,  particularly 
those  residing  in  rural  districts,  do  not  have  laboratory  facilities 
