l-jNew  Agent  in  Pulmonary  Tuberculosis. 
171 
The  following  indicates  the  types  of  cases  studied : 
Stage  I. 
Stage  II. 
Stage  III. 
Number  of  cases.  ..1  (CaseV)      4  (Cases  XIII,  XIV,     15  (all  other  cases) 
The  other  case,  XXI,  was  the  child  referred  to  with  pertussis, 
following  an  unresolved,  possibly  tuberculous,  bronchopneumonia. 
As  space  is  lacking  for  a  detailed  description  of  each  of  these,  a 
brief  synopsis  of  several,  together  with  the  blood  findings,  and  the 
temperature  curves  of  two,  are  given.  These  are  average  cases,  and 
illustrate  the  points  noted. 
Case  I. — Woman,  34  years,  Stage  III,  improved.  General  con- 
dition poor.  Extensive  infiltration,  both  upper  lobes  with  softening, 
especially  on  left  side,  where  there  is  well  marked  cavitation.  Com- 
plicating nephritis.   Moderately  toxic.    Sputum  positive. 
Red  cells.         Hb.     White  cells.  Weight. 
3,750,000        75         8,200         96        Before  treatment. 
4,960.000        81        13,600        101^     After  one  month's  treatment. 
Constant  racking  cough,  with  thick,  tenacious  sputum.  Sputum 
increased  from  15  Cc.  to  about  150  Cc.  daily  with  relief  of  cough. 
Discontinued  treatment  against  advice,  because  of  being  needed  at 
home,  and,  her  condition  becoming  again  progressive,  she  died  eight 
months  later. 
Case  VI.— Woman,  24  years,  Stage  III,  arrested.  General  con- 
dition poor.  Fairly  diffuse  infiltration,  right  lung  with  softening  in 
upper  lobe  anteriorly.  Thickened  pleura  with  adhesions,  lower 
portion.   Infiltration  left  apex.   Little  toxaemia.    Sputum  positive. 
Red  cells.  Hb.  White  cells.  Weight. 
4,100,000  75         10,000  84  Before  treatment. 
5,100,000  92        13.300  99  After  six  weeks'  treatment. 
5,552,000  78        15,060  103^  After  yl/2  months'  treatment. 
These  cases  illustrate  the  effect  upon  the  sputum  with  relief  of 
cough,  the  changes  in  the  blood  picture,  and,  what  is  usually  observed 
and  is  an  indication  of  such  result,  a  white  cell  count,  which  remains 
high  in  favorable  and  arrested  cases.  In  several  instances,  though 
not  uniformly,  the  haemoglobin  percentage  has  fallen  after  ceasing 
treatment. 
Case  VII. — Woman,  24  years,  Stage  III,  improved.  General  con- 
dition fair.    Infiltration  right  upper  lobe  without  softening.  Diffuse 
XVI,  XVII) 
