74 VACCINE AND SERUM THERAPY. 



three isolations, the organisms being isolated from the lesions of 

 chronic marked furunculosis, from an acute boil on the face, and 

 from a patient having multiple pustules on the back of the neck. 

 Most patients suffering with furnucles and carbuncles show a 

 marked improvement within twenty-four hours after injection 

 and some of these patients remain well after that. Everyone 

 who has treated a number of patients suffering with furuncles or 

 carbuncles must have observed that there occasionally is recur- 

 rence of these conditions after apparent recovery following upon 

 the injection of suitable vaccines. If Wright's method of vacci- 

 nation according to the opsonic index is followed out, there are 

 apparently more recurrences than when the injections are given 

 at intervals not less than seven days nor greater than ten days. 

 In all cases the best results will be obtained if a small incision is 

 made in the carbuncle or furuncle twenty-four hours after vacci- 

 nation. By this method the collection of leucocytes or pus is 

 drawn off, the pressure is relieved and the bacteria ingested by 

 the leucocytes are removed. The advantage of this becomes 

 evident when it is realized that staphylococci secrete a leucocidin, 

 which destroys leucocytes. If the leucocytes containing bacteria 

 can be removed before they are killed the value of phagocytosis 

 in immunity is evident. After this the pus is evacuated daily 

 from the furuncle or carbuncle and the wound is not allowed to 

 heal until it has been found that for several days no more pus is 

 being formed. In addition to draining the furuncle or carbuncle 

 through a slight incision, thorough cleansing of the skin with 

 benzine is of great advantage in preventing the formation of new 

 foci. The doses used in most clinics for these conditions are gradu- 

 ally increased, the first injections usually consisting of three 

 hundred million cocci. As was mentioned before, apparently 

 better results are obtained when at the first injection six hundred 

 million cocci constitute the dose, while the later doses contain 

 fewer cocci, at times only one hundred million. While this method 

 of vaccination does not depend for its results only on the effects 

 of vaccines, still it is a method which gives good results without 

 the formation of large scars. 



Acne vulgaris has been successfully treated by vaccination 

 only in certain cases. The value of bacterial injections in this 

 condition was so emphasized by Wright that for a time it was 



