Am Ap?iir" i9?5 rm' }         Ag^t  in  Pulmonary  Tuberculosis.  169 
These  experiments  have  been  repeated  many  times,  in  the  same 
manner,  with  uniform  results,  and  from  them  it  seems  conclusive 
that  oxypinene  is  a  germicidal  gas,  of  high  efficiency,  which  is  at 
once  respirable  and  easily  produced,  continuously,  in  large  quantities. 
Figs.  1  and  2  are  photographs  from  agar-agar  Petri  plates  upon 
which  were  planted  pure  cultures  of  M.  pyogenes  aureus  and  B.  an- 
thracis.  Similar  experiments  with  similar  results  were  made  with 
cultures  of  B.  typhosus,  B.  coli  communis,  and  B.  subtilis,  but  lack  of 
space  has  necessitated  our  omission  of  illustrations  of  the  same. 
These  plates  were  exposed  to  the  action  of  oxypinene  for  two  and 
one-half  hours,  in  a  room  of  about  2500  cubic  feet  capacity,  in 
which  the  generator  was  constantly  operating  and  keeping  it  fairly 
well  filled.  Control  plates  were  made  of  each  organism,  and  both 
exposed  and  control  plates  were  incubated  for  seventy-two  hours. 
Clinical. — Observations  were  made  of  twenty-one  patients.  As 
with  two  exceptions  they  were  of  the  dispensary  class,  they  were 
difficult  to  control  for  so  long  a  period  as  could  be  desired,  some 
insisting  upon  their  discharge  with  the  alleviation  or  disappearance 
of  their  active  symptoms.  With  the  exception  of  Case  V,  a  very 
early  tuberculous  infection,  and  Case  XXI,  a  child  ill  with  pertussis, 
following  an  unresolved  bronchopneumonia,  all  were  in  the  second 
or  third  stage  of  pulmonary  tuberculosis  (Classification  of  the 
National  Association  for  the  Study  and  Prevention  of  Tuberculosis), 
and  tubercle  bacilli  were  demonstrated  in  the  sputum.  It  seemed 
desirable  to  select  lesions  of  such  severity,  but  equally  so  that  they 
should  offer  some  hope  of  improvement,  in  order  that,  so  far  as 
possible,  the  amelioration  of  symptoms  which  so  often  follow  any 
change  in  environment  and  dietetic  regime  might  be  discounted.  How- 
ever, to  study  fully  the  effects  of  oxypinene  upon  special  symptomatic 
features  or  types  of  disease,  such  as  active  hemorrhage,  marked 
pyrexia,  constant  dyspnoea,  tuberculous  laryngitis,  acute  phthisis, 
chronic  pulmonary  tuberculosis,  and  the  toxaemia  of  extensive  cavita- 
tion with  secondary  infection,  certain  patients  were  admitted  to  treat- 
ment whose  prognosis  seemed  hopeless,  and  who,  though  showing 
for  a  time  the  beneficial  effects  so  generally  observed  in  the  others, 
finally  died.  With  the  exception  of  Cases  XX  and  XXI,  who  were 
treated  in  their  own  homes,  the  entire  group  was  observed  in  a 
private  hospital  in  the  city  for  three  months,  and  thereafter  for  five 
and  one-half  months  in  a  private  sanatorium  in  the  country.  The 
periods  of  observation  varied  from  nine  days  to  nine  months.  With 
