CONCENTRATIONS OF DIFFERENT VACCINES 211 



Proper dilution of the emulsion is next undertaken. Small bottles 

 containing 25 c.cm. of 1/2 per cent, carbolic acid in sterile saline are aseptic- 

 ally closed with rubber caps; for example, it is desirable to make up these 

 25 c.cm. with staphylococcus vaccine so that each cubic centimeter contains 

 500 million bacteria, then 



(desired amt. to each c.cm.) 

 500,000,000 X 5 No. of c.cm. desired 



6,000,000,000 (dose of original emulsion per c.cm.) 



2.08 c.cm; or approximately 2 c.cm. of the original emulsion must be added 

 to the 25 c.cm. (to be exact 23 c.cm.) to make up the desired dilution. 



The rubber cap is finally coated with melted paraffin wax. 



For stock vaccines it is best to make up the different vaccines in the fol- 

 lowing concentrations: 



1. Staphylococcus vaccine prepared from various strains of staphy- 

 lococcus, aureus, citreus, and albus, in three concentrations: 1000 million, 

 500 million and 100 million, to the c.cm. 



2. Streptococcus vaccine in 20 mil., 10 mil. and 5 mil. concentrations. 

 Since the streptococcus grows very sparingly, cultures of two or three days' 

 growth may have to be employed for the preparation of a vaccine, and even 

 then it may be necessary to use one broth culture instead of sterile salt 

 solution to emulsify the agar cultures. On standardizing such thin 

 vaccines it is frequently necessary to take one volume of blood to two, 

 three, or even more volumes of emulsion and then calculate accordingly. 



3. Acne vaccine in 20 mil., 10 mil. and 8 mil. 



4. Mixed acne in 20 mil. acne and 500 mil. staphylococcus. 



5. Gonococcus vaccine in 50 mil. and 5 mil. Gonococcus vaccines are 

 best employed as autogenous vaccines. 



6. Typhoid vaccine in 1000 mil. and 2000 mil. for prophylactic inocu- 

 lation. 



7. Colon vaccine in 25 mil., 10 mil., 5 mil. Vaccines of coliform organ- 

 isms are very easily emulsified ; as a rule they should not be older than twelve 

 hours and not be sterilized for more than three quarters of an hour. 



With the exception of the staphylococcus vaccines, it is advisable not to 

 use stdck vaccines, but autogenous vaccines, i.e., vaccines made from the 

 specific strain of bacteria causing the infection to be treated. It is very 

 important to isolate the supposed pathogenic organism from the innocuous 

 or less pathogenic bacteria contaminating or complicating the infection. 



In tuberculosis Wright employs a dilution of Koch tuberculin (T. R.). 

 Recently he has prepared a tubercle bacillus vaccine in the same way as the 

 other bacterial vaccines. 



The initial dosage varies with the different vaccines, but should in 

 general be about 100 to 500 million of staphylococci; one may go as high as 

 2,500 or even 5,000 millions. 



