STREPTOCOCCUS VACCINE. 75 



the common belief among clinicians that vaccinations with killed 

 cultures of Micrococcus pyogenes albus were applicable in all cases 

 of acne. This, however, is not the case. In the lesions of many 

 patients suffering with acne vulgaris, the white skin coccus cannot 

 be found. In such cases either the species of organisms causing 

 the pustules must be injected or else vaccine treatment should 

 not be applied. A number of the cases of acne which have been 

 treated by the writer have failed to show microorganisms that 

 could be cultivated. When the vaccine treatment is used other 

 means of treatment must not be discontinued. Incisions and 

 evacuation of the pustules, cleansing of the skin with benzine, 

 expression of comedones or black heads, the bathing of the infected 

 part in hot water, application of sulphur or other suitable lotions 

 and the regulation of the diet are all of assistance to overcome 

 this disease. Even under these measures the treatment is not 

 always successful. 



The treatment of sycosis barbae or barber's itch with staphy- 

 lococcus vaccines has not always been as successful as has been 

 reported. Two patients with this disease in the City Hospital 

 in New York City, were treated by Ross with injections of staphy- 

 lococcus vaccine. No satisfactory results, however, were obtained. 

 The unsatisfactory results obtained by the injection of staphy- 

 lococcus vaccine is easily explained when it is realized that sta- 

 phylococci cause secondary infections in only some of the cases 

 of sycosis barbae. In these cases only can staphylococcus vaccine 

 be of benefit. 



Streptococcus Infections. Various kinds of streptococcus in- 

 fections have been treated by vaccines. Usually these infections 

 are acute and severe and it often is a question whether sufficient 

 time for the production of immune bodies as a result of vaccina- 

 tion will elapse before death or spontaneous recovery terminates 

 the disease. Arthrites, pneumonia, pericarditis, erysipelas, local 

 infections and endocarditis, etc., have been treated by the use of 

 vaccine. At times striking results have been obtained, while 

 in other cases not treated by vaccination there has been equally 

 striking recovery. One needs only to remember the cases of ! 

 streptococcus infections of the uterus, of septicaemia and ery- ; 

 sipelas that recover in a few days without any specific 

 treatment, to realize that it is easy to attribute beneficial results 



