BACTERIAL VACCINES 285 



vaccine from the lesion, use three or four doses and if more 

 are necessarily make up a new vaccine. 



If the above statements are borne in mind and vaccines 

 are made and administered accordingly the author is well 

 satisfied that much better results will be secured. 



In accordance with the theory on which the use of vac- 

 cines is based, i. e., that they stimulate the body cells to 

 produce immunizing antibodies, it is clear that they are 

 especially suitable in those infections in which the process is 

 localized and should not be of much value in general infec- 

 tions. In the latter case the cells of the body are stimulated 

 to produce antibodies by the circulating organisms, prob- 

 ably nearly to their limit, hence the introduction of more of 

 the same organisms, capable of stimulating though dead, is 

 apt to overtax the cells and do more harm than good. It is 

 not possible to tell accurately when this limit is reached, but 

 the clinical symptoms are a guide. If vaccines are used at 

 all in general infections they should be given in the early 

 stages and in small doses at first, with close watch as to 

 the effect. In localized infections only the cells in the 

 immediate neighborhood are much stimulated, hence the 

 introduction of a vaccine calls to their aid cells in the 

 body generally, and much more of the resulting antibodies 

 are carried to the lesion in question. Manifestly surgical 

 procedures such as incision, drainage, washing away of dead 

 and necrotic tissue with normal saline solution, not necessarily 

 antiseptics, will aid the antibodies in their action and are to 

 be recommended where indicated. 



In the practical application of any remedy the dosage is 

 most important. Unfortunately there is no accurate method 

 of determining this with a vaccine. Wright recommended 

 determining the number of the organisms per cc as before 

 mentioned, and his method or some modification of it is 

 still in general use. From what was said with regard to 

 variation, both in organisms and in individuals, it can be 

 seen that the number of organisms is at least only a very 

 rough guide. This is further illustrated by the doses of 

 staphvlococcus vaccines recommended by different writers, 

 which vary from 50,000,000 to 2,000,000,000 per cc. The 



