VACCINE THERAPY IN THEORY AND PRACTICE 615 



patient's condition. The results of this treatment have been 

 highly satisfactory : two years after discharge 119 patients out 

 of 164 were found to be at work. 



Inman investigated the opsonic index in cases under this 

 treatment, demonstrated that a series of auto-inoculations were 

 being induced, and showed that in some cases no amount 

 of work produced any influence on the index. Such patients 

 were considered to be cured. 1 



Latham has recently introduced an innovation in the method 

 of administration of vaccines. On the ground that there is 

 reason to believe that pulmonary tuberculosis is generally 

 due to infection through the alimentary tract, he gave first 

 tuberculin and afterwards other vaccines by the mouth. 2 

 Roughly, twice the ordinary hypodermic dose is given, with 

 the addition of fresh horse serum, which promotes absorption 

 and appears to have other therapeutic value. It is essential- 

 to give the vaccine on an empty stomach. A satisfactory 

 immunising response is found to follow the administration. 

 It is not clear that this method has any advantage over the 

 hypodermic ; with a sharp needle the operation itself is the 

 merest trifle, and the vaccine can be introduced direct into a 

 suitable site. By the indirect method it is impossible to 

 guarantee absorption, and it seems to be a reactionary step 

 to work in the dark in preference to the light. 



Wright long ago expressed his belief that the physician 

 of the future will be an immunisator; it would seem that the 

 physician of the present is becoming one, but this method has 

 not yet taken the place in medicine which is its due. We are 

 still only at the beginning of things ; the door is open, but we 

 are as yet only on the threshold ; there is research for all who 

 seek it in entirely unbroken ground, there is means of treating 

 cases hitherto deemed incurable. As surely as the principles 

 introduced by Lister dominate surgery, so surely will vaccine 

 therapy dominate the treatment of infective disease. 



Author's Note. — I have to acknowledge the kindness of Sir 

 Almroth Wright, M.D., F.R.S., in allowing me to use the 

 proofs of his collected papers, now in the press, for the com- 

 pilation of this article. 



1 Paterson, also Inman, Lancet, Jan. 25, 1908. 



2 Latham, loc. cit. 



