ACTIVE IMMUNIZATION FOR THERAPEUTIC PURPOSES 211 



Standard Doses. As standard doses of the different vaccines, or 

 bacterins, as bacterial vaccines are now termed, the following may be 

 recommended, bearing in mind what has been said in the foregoing 

 lines: 



Staphylococcus aureus . . . . . . 50,000,000 to 500,000,000 (or more) 



Staphylococcus albus and citreus . . 100,000,000 to 1,000,000,000 (or more) 



Streptococcus pyogenes 5,000,000 to 100,000,000 (or more) 



Gonococcus 5,000,000 to 100,000,000 (or more) 



Friedlander's bacillus 10,000,000 to 100,000,000 (or more) 



Colon bacillus ....... 10,000,000 to 100,000,000 (or more) 



Of the tubercle vaccine it is recommended to begin with very 

 small doses, i. e., SOTOT to TBTTFTF of a milligram, and to continue 

 the same dose or gradually increase it, according to the indications 

 of the individual case (see Tuberculosis). 



Indications for the Use of Bacterial Vaccines. As I have already 

 indicated in a general way, bacterial vaccines may be employed in 

 practically any infection which has a tendency to a certain degree 

 of chronicity. It has been recommended in the various chronic 

 infections of the bones and joints (tuberculosis, osteomyelitis, 

 arthritis) in the early stages of pulmonary tuberculosis, in chronic 

 gonorrheal infections, in the colon bacillus infections of the urinary 

 tract, in tubercular cystitis, in the chronic Staphylococcus infections 

 of the skin (lupus, scrofuloderma, tuberculides), in chronic inflam- 

 mation of the middle ear, the antrum, the frontal sinus; also in 

 endocarditis, as a postoperative measure in connection with empyema, 

 etc. 



Of special interest is the recent announcement by Billings and 

 Rosenow that in cases of Hodgkin's disease marked improvement 

 follows the use of vaccine prepared from cultures of the diphtheroid 

 baccillus which has been isolated from the lymph glands of such 

 cases by Bunting and Yates, and Negri and Mieremet, and which 

 seems to bear a causative relation to the disease. 

 y. While acute infections have generally been regarded as contra- 

 indicating the use of vaccines, this has largely been on theoretical 

 grounds. Personally, I have gained the impression that vaccination, 

 even in such cases, could do some good. However, it is just in such 

 cases that correct judgment is frequently fallacious and difficult. 

 Rosenow has recently advocated the use of partially autolyzed 



