300 THE PRINCIPLES OF IMMUNOLOGY 



basis. According to the work of Walker and his collaborators, certain 

 of the cases are due to specific bacterial invasion, and probably con- 

 tributed to by a certain degree of hypersusceptibility to the organism. 

 Bacterial vaccination in these cases has been accompanied by good 

 results. A complete investigation of the nature of the case is essential 

 before any form of vaccine treatment should be attempted. Earlier 

 investigators have employed mixed vaccines made of organisms obtained 

 from the sputum. 



Pertussis. Prophylactic vaccination against this disease has been 

 discussed (page 294). Therapeutic vaccination has been employed by a 

 number of workers with, in many instances, apparently favorable re- 

 sults. Luttinger found that in a series of 952 cases treated by vaccina- 

 tion the paroxysmal stage averaged about thirty-seven days, whereas 

 149 cases not treated with vaccine had a duration of over fifty days. 

 Blum and Smith found that non-specific vaccination was practically as 

 effective as vaccination with the bacillus of Gengou. Barenberg also 

 finds that pertussis vaccine, even when given in large doses, has neither 

 curative nor ameliorating effect. Kraus and others have reported good 

 results by the use of a vaccine prepared from the sputum. The sputum 

 is washed, mixed with ether, shaken for three or four days, the ether 

 evaporated, the mixture tested for sterility and given in doses of i.o c.c. 

 every three or four days. If stock vaccines of the organisms are em- 

 ployed, it is of the utmost importance that they be fresh. Doses of 

 25 million organisms may safely be given. 



Pneumonia. Prophylactic vaccination (page 292) is distinctly 

 more promising than therapeutic vaccination. Treatment with immune 

 serum (page 256) is also more promising than vaccination. Coleman 

 is of the opinion that vaccines in pneumonia are never harmful and 

 may be beneficial. Teale and Embleton believe that they have obtained 

 good results in certain cases. Shera expresses the belief that the local 

 infection is too massive to permit of vaccine having any appreciable 

 effect in the stage of consolidation. The frequent occurrence of pneu- 

 mococcus septicemia as a part of the disease makes it unlikely that 

 vaccination will be helpful. In delayed resolution vaccines are of value 

 in some cases. Shera also states that empyemia when it has reached the 

 chronic stage may be benefited by specific vaccination. 



Other Diseases. Certain diseases of the accessory regions of the 

 respiratory tract, including chronic median otitis and mastoiditis, have 

 been treated by vaccination with the organism concerned. Results 

 have been variable, but inasmuch as these represent somewhat isolated 

 local infections it is reasonable to attempt vaccination in addition to 

 the usual modes of treatment. 



DISEASES OF THE EYE 



When conjunctivitis becomes chronic, specific vaccination sometimes 

 leads to improvement. The infecting agents include staphylococcus, 

 streptococcus, bacillus pyocyaneous, Friedlander's bacillus and others. 

 Autogenous vaccines may be employed in addition to other modes of 



