BACTERIAL VACCINE. 07 



The point of injection of bacterial vaccines is considered by 

 Wright to be of importance in the success of vaccination. Those 

 regions of the body are selected where there is rapid absorption 

 by the lymph and blood. It has been found that on subcutan- 

 eous injection greater amounts of immune body are formed than 

 upon intravenous injection. This is especially illustrated in 

 the production of certain haemolytic sera. 



If Wright's method of vaccine treatment of bacterial diseases 

 is to be judged it must be remembered that the injection of killed 

 cultures did not originate with Wright, but that Wright has added 

 opsonic index determinations to control the time and doses of 

 these injections. Opsonic index determinations have, however, 

 been found to be open to so many sources of error, of such great 

 variability in health, disease and after injections of vaccines, that 

 many clinicians have decided upon the dosage and inter-spacing 

 of injections by clinical symptoms rather than based upon opsonic 

 index determinations. Most clinicians have, in the first injection, 

 used the dosage recommended by Wright but in subsequent in- 

 jections have used such amounts as seemed warranted and indi- 

 cated. Hektoen, adhering to the reliability of opsonic index de- 

 terminations, holds that the index is of diagnostic and prognostic 

 importance, while Park, Cole, Bolduan and others regard the index 

 as unreliable for such purposes. 



ORGANISMS USED IN VACCINATION. 



Many of the species of pathogenic bacteria have been used in 

 active immunization. Two kinds of vaccine treatment have been 

 employed, one consists of the injection of killed cultures of the 

 causal organisms and the other of the autoinoculation from the 

 infected focus by means of massage and manipulation. 



In the injection of vaccines, so called "stock culture" vac- 

 cines and "personal" or "autogeneous" vaccines have been used. 

 It has been found that for some organisms, vaccines made from 

 stock cultures will give as good results as will personal or auto- 

 geneous vaccines. Stock vaccines have the advantage that no 

 time need be lost in the preparation of the vaccine, and for nearly 

 all of the species of bacteria causing infections amenable to treat- 

 ment by active immunization, stock vaccines are equally as good 

 as autogeneous vaccines. The principle exceptions are the vac- 



