ABSTRACTS 



367 



tion of three doses is compulsory four years after the first course of 

 three doses. 



3. The kind of vaccine used may account for some failures. 



a. Whole killed vaccine. 



(1.) The strain of bacillus used may not be suitable. 

 (2.) The method of preparation may be faulty. 

 (3.) The vaccine may be too old. 



b. Sensitized vaccine. 



(1.) Sensitization may diminish the immunizing properties of 

 the vaccine. 



(2.) Discarding the supernatant fluid may lessen the immunizing 

 power of the vaccine. 



4. The conditions of a soldier's life do not protect him from exposure 

 to typhoid fever in his vicinity. 



5. The Army vaccine is probably superior to some of the vaccines 

 available for the general population. 



The writer comes to the conclusion that soldiers are better protected 

 than those who become infected after vaccination in civil life, and that 

 this protection must be due either to better vaccination in point of 

 numbers of doses and intervals of revaccination, or to a better vaccine. 

 Of the two factors the vaccine is probably the most important. 



E. B. V. 



Methods of Using Diphtheria Toxin in the Schick Test and of Controlling 

 the Reaction. Abraham Zingher. (American Journal of Dis- 

 eases of Children, 1916, 4, 269-277.) 



The Schick reaction consists in the intracutaneous injection of one- 

 fiftieth M.L.D. of well ripened diphtheria toxin and indicates the 

 absence or presence of a protecting amount of antitoxin in the blood 

 according to whether there is or is not produced a local inflammatory 

 reaction. In some individuals there occurs a so-called pseudo-reaction 

 which probably bears no relation to the free toxin but is the result of 

 an anaphylactic reaction with the proteins of the diphtheria bacilli. 

 The true and the false reactions can usually be distinguished by their 

 appearance and time of occurrence but as a further control a super- 

 heated (75°C.) toxin or one which has been over neutralized by the 

 addition of two units of antitoxin to each L plus dose of toxin may be 

 injected into the opposite arm. 



The author also emphasizes the importance of careful technique in 

 giving the injection so that it is definitely intracutaneous. The value 

 of the test now seems well established and especially prepared vial& 

 containing undiluted toxin and with directions concerning its dilution 

 are prepared by the New York City Board of Health and also by com- 

 mercial laboratories. 



Of a thousand children admitted to the Willard Parker Hospital, 

 who gave a negative Schick reaction and who were more or less exposed 

 to diphtheria not a single one developed the disease. 



Tests on 2700 normal children in orphan asylums between the ages 



