6io SCIENCE PROGRESS 



of immunising response ; and a last, but important practical 

 point is that the method makes great demands on the time 

 both of the patient and his physician. 



The study of auto-inoculation suggests certain indications 

 in the treatment of disease with constitutional symptoms ; 

 these symptoms are the result of auto-inoculations of unknown 

 strength, and until these are stopped the use of measured 

 doses of vaccines cannot be advantageously employed. The 

 guiding principle in pyrexial conditions, then, must be to 

 secure rest in order to put a stop to auto-inoculation, and then 

 to adopt properly controlled vaccination. 



This applies especially to the treatment of pyrexial phthisis. 

 All exercise, every fit of coughing, even breathing, induce an 

 auto-inoculation, and the lungs can never be completely 

 controlled. The indication is for the most complete rest, the 

 effect of which in the reduction of temperature is well known. 

 When this is successful it may result in converting the general 

 into a strictly local disease ; and if this is brought about, it may 

 then be possible to initiate treatment either by auto-inoculation 

 or vaccine therapy. It has been suggested that where it is 

 desirable to induce a lymph flow through any focus, this may 

 be assisted by the ingestion of citric acid to decrease the 

 viscidity of the blood. Similarly, when auto-inoculation is to be 

 checked, this will be helped by ingestion of calcium, either as 

 milk or otherwise, in order to increase the coagulability of the 

 blood, and to make it thicker. 1 



It will be clear from the foregoing that the cases which are 

 best adapted for inoculation treatment are strictly localised 

 bacterial infections ; that when there is evidence of general 

 infection every effort must be made to check auto-inoculation, 

 and to reduce such an infection from a general to a local 

 one. Having done this, inoculation should be undertaken with 

 appropriate vaccines, in suitable doses and at suitable intervals : 

 inattention to these points will give unfavourable results. As 

 the opsonic content of the blood is raised it should be deter- 

 mined to the focus of infection by some physical means ; stagnant 

 fluids should be removed mechanically, and coagulation in 

 sinuses prevented ; and, if necessary, the fluidity of the blood 

 may be increased by the use of citric acid. 



With regard to the treatment of general septicaemia, in 



1 Wright, Lancet, Aug. 17 and 24, 1907, 



