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SummaryA mouse protection test in which penicillin products are used prophylactically against subsequent challenge with Pneumococcus Type I is described. This test was used to evaluate repository type dosage forms of the antibiotic agent for their ability to prolong a period of protection against infection. Of the preparations tested the nonrepository aqueous solution of sodium penicillin was least effective, tlhe suspensions of procaine penicillin in water or in oil were approximately equal in their activity, large particle size sodium penicillin in beeswax and oil was more effective, and small particle procaine penicillin suspended in oil and aluminum monostearate was the most effective preparation tested.

ConclusionsThe previous observation that only a slight and inconstant prolongation of penicillin blood levels is obtained by the use of a water-in-oil emulsion is confirmed. The present findings suggest further that a substantial increase in the intramuscular dose of penicillin in the same volume of saline will give considerably higher and better sustained plasma levels than the smaller dose given in a water-in-oil emulsion and the disadvantages of the latter method are thus avoided.

• An arterial homograft bank was established to supply freeze-dried segments of human arteries for use in surgery. Analysis of the results from the first 100 preparations used shows that 36 were used in repairing aneurysms of the abdominal aorta and 24 in relieving arteriosclerotic obstruction in peripheral arteries, with results considered good in 24 and 20 cases respectively. Uniformly good results were obtained in 13 cases of obstruction of the terminal portion of the aorta and 11 cases of coarctation. Mortality was high in ruptured, but low in unruptured, aneurysms of the abdominal aorta. The preparation of materials for the arterial homograft bank can be undertaken by large community hospitals without additional highly trained personnel.

The problem of prevention of recurrent attacks of rheumatic fever has always presented a great challenge to the responsible physician. Prior to the advent of chemotherapeutic and antibiotic agents, the avoidance of streptococcic disease and the general symptomatic care of the patient proved fruitless in attempting to prevent progressive cardiac damage in the patient who had had rheumatic fever. Tonsillectomy has not prevented recurrences of the disease, and now it is usually felt that patients with histories of rheumatic fever have the same indications for removal of the tonsils as do those who have not been afflicted with the disease. The strongest evidence for a direct relationship between rheumatic activity and antecedent streptococcic infection has been presented by prophylactic programs. The sulfonamides were used in the first direct approach to the prevention of recurrences by attempting to keep the throat free of beta hemolytic streptococci of Lancefield group A. Because

Buckwalter and Dickison 1 recently reported a new repository type of penicillin product. 2 They introduced the principle of suspending penicillin salts in peanut oil gelled with aluminum stearates, water repellent substances. They compared the absorption-delaying properties of this vehicle with the conventional repository vehicles in animals. The study recorded here was designed to carry this comparison further—in human subjects. The facilities of four assay laboratories were used, and assays were performed by two different methods, a modified Rammelkamp method and a cup plate procedure employing Sarcina lutea. Control samples of blood were drawn before the injection; each patient then received 300,000 units of penicillin in repository form, and consecutive samples of blood were taken at the intervals indicated on the chart. The lines on the chart are the lines fitted by the method of least squares to the logarithm of the average blood concentration with time in hours. Table