134 Active Immunkation to Hay Fever [March, 



Clowes (20) was one of the first investigators In this country to 

 immunize hay fever patients with pollen extracts. He performed 

 complement-fixation tests, before and during the treatment, and 

 showed that an increase in antibodies is produced in a few weeks. 



The scarification method is the one we have generally used to 

 diagnose and determine the degree of immunity induced. The 

 wheal produced by the initial vaccination is measured, its time of 

 appearance and its duration noted. After five or six treatments 

 the patient is revaccinated and the wheal is observed again as before, 

 and compared with the former results. When the wheal is very 

 small or does not appear, the patient is sufficiently immune and 

 probably will go through the season with very mild Symptoms or 

 none at all. 



Naturally the question arises whether such immunization is 

 permanent. We believe it is safe to say that, while immunity may 

 not be successfully carried over to the succeeding year, recurrences 

 are much milder at least and require less re-immunization. An 

 attack the following year can probably be overcome by a few 

 injections. 



The best time to begln treatment is probably about ten weeks 

 before the attack may be expected to occur. Regulär ity of at- 

 tendance at about weekly intervals is important. 



We feel that eures were not accomplished in two cases because 

 treatment was begun too early; and in two other cases, because the 

 patients were treated too irregularly. Furthermore, it is probable 

 that some of these cases were susceptible to pollen other than that 

 from ragweed and golden-rod. At the time of our initial work, 

 we were not pr epared with as large a variety of pollens as we now 

 possess for the continuance of this work. 



Our heartiest thanks are due to Dr. Wm. J. Gies, for assistance 

 in the conduct of the work done at the College of Physicians and 

 Surgeons; also to Dr. E. P. Bernstein, for many valuable sug- 

 gestions. 



