DISCUSSION. 215
ing the throat, using a gargle of 1/1000 permanganate in 15 per cent, solution sodium sulph., will cause dispersion of the meningococci from the pharynx ; also spraying the posterior naso-pharynx with a preparation of menthol, grs. viii. ; iodine, grs. iv. ; purolein, ad* 5i.
Surgeon-General Sir David Bruce : Then you have no knowledge of the use of serum locally ?
Dr. R. A. O'Brien (in response to the President's summons) : I am afraid the only information I can supply bears on this very depressing question of the inefficiency of the SQi'um we had in the early part of last year. From clinical accounts, I think there is no doubt that none of the sera available for treatment was of very great use. That was rather borne out l)y the examination of the serum in the laboratory. I do not know whether the strain of meningococcus occurring in England changed in any way. It looks as though they had, and yet when one compares them, one finds that most of the strains obtained to-day do correspond with the strains worked with years ago, i.e., meningococci and para-meningococci. People who were making serum had the original strains of coccus, and they were immunising their* horses with them ; but it nevertheless remains a fact that all the serum available in the early part of 1915 had very little antibody reaction to strains isolated at that time. To-day it is all altered. Those in England who are making serum have obtained many strains from cases occurring on the Continent and in England, and are using them. Dr. Flexner very kindly sent me cover some of his latest serum, obtained about the middle of the year, and it had exceptionally high content of antibodies. He had English strains sent over to America, and ] believe that he found the earlier New York serum had a very low antibody content against such strains. Serum now obtainable in England has very high antibody content, and this is rather borne out by the fact that favourable clinical results have been reported from a number of sera now being used.
Surgeon-General Sir David Bruce : The Society owes a debt of gratitude to Major Atkinson for his excellent description of the meningococcus. As far as my second-hand knowledge goes, his paper gives fully and accurately the facts as known up to the present day.
