80 VACCINE AND SERUM THERAPY. 



vaccine usually is made from bouillon cultures. The organisms 

 are killed by one hour's exposure to 53 C. to 60 C. Pfeiffer and 

 Kolle inject sufficient amounts of vaccines to produce a local reac- 

 tion lasting several days, and a general reaction, as is demon- 

 strated by fever and malaise, lasting one to two days. Following 

 the first injection, two to three injections of increasing amounts 

 are made at intervals of eight days. The English method also 

 produces marked disturbances at times. The duration of immunity 

 conferred by this method of treatment varies, and is usually re- 

 garded as lasting from one to three years. The results of such im- 

 munization are still doubtful but statistics indicate that immunized 

 individuals are less likely to contract the disease, and that when 

 the disease is contracted it is less severe and less often fatal. 



Typhoid bacillus vaccine has been tried in the treatment of 

 typhoid fever. Here it has met with but little success. The best 

 results with the vaccine have been obtained in cystitis, cholecysti- 

 tis, and the local abscesses following attacks of typhoid fever. The 

 doses injected range usually from five million to fifty million bacilli, 

 the injections being repeated at intervals from eight to ten days. 

 Autogenous vaccines usually give the best results. 



Bacillus dysenteriae Infections. Vaccines made from dysen- 

 tery bacilli have been used in prophylaxis as well as treatment of 

 bacillary dysentery. Inasmuch as there are different strains of 

 these bacilli, it is advisable to use vaccines made from the cultures 

 isolated from the patient or with all of the different strains of B . 

 dysenteriae. 



Shiga has tried various methods of active immunization and 

 has found that the best results are obtained either, by injecting 

 subcutaneously anti-dysenteric serum and killed cultures of dysen- 

 tery bacilli, or, by taking by mouth the killed cultures of this organ- 

 ism. By Shiga's method of simultaneous injection of anti-dysen- 

 teric serum and dysentery vaccine the death rate in Japan due to 

 bacillary dysentery has been much reduced. The duration of im- 

 munity, according to Shiga, is about two months. 



Vaccine treatment of dysentery can only be applied in cer- 

 tain cases. By the method of active immunization, immunity can- 

 not be established in much less than eight days, and for this reason 

 only subacute or chronic cases are amenable to treatment by vac- 

 cines. The number of cases treated by this method is still too 



