ACTIVE IMMUNIZATION FOR THERAPEUTIC PURPOSES 207 



so far as we know, upon the disease, when this has once been estab- 

 lished, it appears from recent studies that vaccination may advan- 

 tageously be employed as a curative agent, in those infections which 

 are characterized by a tendency to chronicity, and in which toxins 

 play little or no role. The credit for having established this possi- 

 bility, and for its popularization, undoubtedly belongs to Wright. 



Wright's concept of the rationale underlying the tedious course 

 of some of these infections is essentially based upon the supposition 

 that the autovaccinations which take place in the body of the infected 

 individual are imperfectly interspaced as regards point of tune and 

 improperly adjusted as regards dosage, the consequence being that 

 the formation of certain protective substances, and notably of the 

 opsonins, takes place irregularly and insufficiently. He expressed the 

 opinion that by following the opsonic curve indications might be 

 obtained for the introduction of the corresponding organisms from 

 without as vaccines, both as regards the size of the dose and the 

 frequency of the injections, and that it might thus be possible to 

 favorably influence such infections as acne, sycosis, furunculosis, 

 endocarditis, chronic cystitis, pyelitis, tuberculosis, etc. For a 

 consideration of the details underlying Wright's opsonic studies, I 

 must refer the reader to Wright's own publications, and the chapter 

 on the opsonins in the first part of the present work. I Suffice it to 

 state at this place that the opsonic index unfortunately did_npt fulfil 

 those expectations with which it was at first greeted, and that any 

 attempts at vaccine treatment must still be made upon a more or 

 less empirical basis, and with no more definite or accurate index 

 to dosage and frequency of injection than is afforded by the clinical 

 symptoms. But even so, there can be no doubt that a certain amount 

 of good may be accomplished; how much, it is yet impossible to say. 

 So much depends upon the individual case, coincidence, the personal 

 factor in the observer, etc., that conclusions should only be drawn 

 with great care. As yet we certainly do not know enough of what 

 may or what may not be accomplished to warrant any dogmatic 

 statements. 



Preparation of the Vaccines. A great deal of discussion has arisen 

 regarding the question whether or not it is imperative to use au- 

 togenous vaccines, i. e., vaccines that are derived from the individual 

 organism which is responsible for the particular infection, or whether 

 it is permissible to make use of stock vaccines, which may in turn be 



