66 VACCINE AND SERUM THERAPY. 



DOSAGE. 



Wright has, by means of the opsonic index determined the 

 proper dosage for the different bacterial vaccines and while he as 

 not stated that definite amounts must be used, still he has sug- 

 gested certain doses. His principle in dosage is to use the smallest 

 dose that will give a good rise in the opsonic index and never to 

 increase the amount injected until it has been ascertained that 

 the doses which have been injected have been too small to produce 

 a good rise in the opsonic index. 



The doses of vaccine recommended by Wright are as follows: 



Bacillus coli 5 to 50 million bacteria 



Micrococcus gonorrhoeas 5 to 50 million bacteria 



Micrococcus pneumonise 10 to 50 million bacteria 



Bacillus pyocyaneus 5 to 5 thousand million bacteria 



Micrococcus pyogenes 50 to 1 thousand million bacteria 



Streptococcus pyogenes 10 to 25 million bacteria 



Bacillus tyhosus 5 to 50 million bacteria 



Koch's New Tuberculin 1-1,000 to 1-400 milligrams 



These doses are by some considered purely arbitrary, because 

 the personal characteristics of the individual to be immunized, 

 the duration, extent and severity of the infection, must all be con- 

 sidered in active immunization. While these doses may be arbi- 

 trary they at least offer some guide as to the number of organisms 

 to be injected at a time. At times in active immunization the in- 

 jection of vaccine is accompanied by injection of specific immune 

 serum. This will pave the way for larger doses and more powerful 

 vaccine injections. 



Injection of the doses recommended by Wright usually pro- 

 duces no constitutional symptoms. Wright has stated that at 

 times malaise, slight general muscular pain and headache are 

 observed on the day following the injection but as the positive 

 phase comes on there is a marked buoyancy of spirits and stimu- 

 lation. Most investigators on this subject have never observed 

 untoward symptoms when the small doses recommended by Wright 

 are injected, while others have at times observed a rise of tem- 

 perature, nausea, vomiting, etc. According to the principle of 

 active immunization probably the greatest amount of immunity 

 results when there is some reaction for in active immunization the 

 individual or animal undergoes a modified or less severe form of 

 the disease. 



