VACCINE THERAPY 297 



quently, immune bodies are not produced in sufficient amounts to 

 combat the infection. Vaccination may serve to stimulate a general 

 immune reaction which aids in the resistance to the local lesion. In 

 generalized infections the simple bacterial vaccines may add to the load 

 carried by the body and perhaps reduce rather than enhance immunity. 

 If, however, immune serum is added to the vaccine or introduced sep- 

 arately, the serum may operate either upon the body or upon the 

 bacteria so as to favor resistance. 



DISEASES OF THE GENITO-URINARY TRACT 



Vaccine Treatment of Gonorrhea. If stock vaccines are to be 

 employed, it is desirable to use those composed of a variety of strains 

 of the organisms. Many of the vaccines employed are heated salt solu- 

 tion suspensions of the organisms. Demonchy advises the use of large 

 doses of unheated salt solution suspensions of stock cultures. Thomson 

 has prepared a so-called detoxicated vaccine. In the earlier method 

 Thomson dissolved the organism in N/io NaOH and precipitated with 

 N.HC1. The toxins remain in the supernatant fluid. Later he found that 

 the toxins could be removed by washing with 0.5 per cent, sodium 

 acid phosphate and 0.5 per cent, phenol. Haworth employed sensitized 

 vaccine, and recently Sezary has recommended lipovaccine. Most in- 

 vestigators recommend the employment of large doses of the organ- 

 isms, ranging from a minimum of 5000 million to a maximum of 

 25,000 million. 



The vaccines have been employed in acute gonorrheal urethritis 

 but with relatively little success. They have also been employed in 

 vulvo-vaginitis in children, in some instances with apparent success. 

 Undoubtedly, the field for therapeusis of this sort is best realized in 

 gonorrheal arthritis. In this condition persistent vaccination has been 

 followed in many cases by excellent results. Somewhat similar are the 

 chronic infections of urethral glands, prostate, seminal vesicles and the 

 internal female genitalia. Results from treatment of these conditions 

 warrant a trial of vaccine treatment in conjunction with other modes 

 of treatment or in those instances where other forms of treatment have 

 failed or are contraindicated. 



Cystitis. The organisms which may cause cystitis are variable, but 

 in those cases where the disease is chronic and resistant to local treat- 

 ment the causative organism usually belongs in the colon typhoid group, 

 the bacillus coli communis being the most frequent offender. In treat- 

 ment of this disease it is of fundamental importance to discover the 

 cause. In cases due to the colon bacillus the vaccine may be given in 

 the form of killed salt solution suspensions of organisms isolated from 

 the case. Stock vaccines may be employed when necessary. The dose 

 is usually from 50 million to 100 million. Results have been extremely 

 variable, but the method is sufficiently well established to justify trial in 

 resistant cases. Of fundamental importance is the removal of ure- 

 thral stricture, prolapse of the bladder or other local conditions which 

 retard cure. 



