STAPHYLOCOCCUS VACCINE. 73 



method is followed, it frequently happens that there may be an 

 exacerbation in the pathological condition. This is especially 

 observed in furunculosis produced by the staphylococci. Fre- 

 quently following the second injection of a vaccine of this organ- 

 ism a new furuncle will appear. The writer has obtained better 

 results by first injecting the largest dose and then at subsequent 

 injections to give constantly decreasing doses. The reasons for 

 following this method are based entirely upon clinical experience 

 and may be due to the fact that if the second and subsequent 

 injections are larger than the preceding one, too much of the im- 

 mune substance is used up in combining with the bacterial vac- 

 cine injected or there may be an actual hypersusceptibility to 

 these organisms. 



The interval between injections when the opsonic index is 

 not determined, lies usually between seven and ten days, which 

 is about the time required for the production of known immune 

 substances. Whenever a reaction follows an injection the in- 

 terval between injections is lengthened so as to allow sufficient 

 time for the disappearance of all symptoms. 



Staphylococcus Infections. The various infections caused by 

 the Micrococcus pyogenes group have been considered most satis- 

 factory for vaccine treatment. In the list of Staphylococcus infec- 

 tions treated by bacterial vaccines, Ross includes boils, carbuncles, 

 acne, sycosis, felons, styes, and septic wounds. The results ob- 

 tained in the treatment of furuncles and carbuncles by killed 

 cultures of the infecting organisms have varied. Probably the 

 best results have been obtained in localized surface infections. 

 In the treatment of these cases it has been found that autogen- 

 ous vaccines are not necessary. It is, however, important in all 

 cases to determine the species and variety of organisms causing 

 the infection and to use this variety in the treatment of the path- 

 logical conditions. The Staphylococcus vaccines with which the 

 writer has obtained the best results are those made from different 

 isolation of the same variety of organisms. Thus a Mic. pyogenes 

 aureus vaccine which has given good results is one made from 



