Diseases of the Lungs

DISEASES OF THE LUNGS Pneumonia.—Study of the causal organism, the pneumo coccus, by Duchez, Gillespie and Cole in America, served to ex plain in some degree the failure of serum treatment in this disease in the past. They have shown that there are at least four types of pneumococcus, each with different serum reactions, called respec tively types I., II., III. and IV. Attempts have been made to pre pare specific anti-sera for each of these, but so far only that for type I. has proved to be of real value in treatment, though a serum has been used in type II. Unfortunately, no effective anti serum has been obtained for type which is responsible for the most serious and fatal form of pneumonia. Pneumococcal vac cines have been used in the treatment of acute pneumonia, but though sometimes successful they have not achieved any wide spread recognition. If they are to be of real value they must be employed early in the course of the disease. It has been recom mended to use a stock vaccine as soon as the disease is recognized, and then if possible to prepare and use an autogenous one. Vac

cines seem to be more helpful in cases of delayed resolution.

Other Diseases.

As regards abscess and gangrene of the lung, although some cases are successfully treated by medical measures, notably in the case of gangrene by injections of arsphenamine, the greatest success has been achieved from improved surgical meth ods.

In the case of tumours of the lung, mediastinum and pleura, the application of artificial pneumothorax promises to render some of these more easy to recognize and to deal with surgically.

With respect to pulmonary mycoses and spirochaetosis, im proved laboratory methods have enlarged our knowledge of condi tions due to some organisms such as moulds and spirochaetes, which occasionally cause pulmonary infections. (For pulmonary tuberculosis see TUBERCULOSIS.)