154 Dr. Wright and Capt. Douglas. Action on [July 26, 



B. 



Child's serum 2 vols. 



A. E. W.'s washed corpuscles ... 2 



Staphylococcus emulsion 1 vol. 



Phagocytic index (average of 20 P.W.B.C.), 12'25. 



(5) Determination of the Course of the Reaction of Immunisation obtained 

 in response to Inoculations of a Staphylococcus Vaccine. 



We have in a very considerable number of cases plotted out by the 

 aid of the phagocytic method the course of the reaction of immunisa- 

 tion which occurs in response to inoculations of a Staphylococcus 

 vaccine. 



A preliminary word or two may be devoted to the description of the 

 mode of preparation of the vaccine. 



The procedure we adopt is as follows : 



We add to a 24 hours' growth of Staphylococcus on sloped agar tube 

 about 10 c.c. of sterile physiological salt solution. Churning up our 

 culture with this, and letting it stand in order to allow all the unresolved 

 bacterial masses to subside, we draw off the supernatant fluid by syphon 

 action into a special form of tube and heat to 60 C. for half an hour. 



We now place the tube in an incubator and incubate for 24 hours 

 in order to allow of a multiplication of any bacteria which may have 

 survived the heating. We now inoculate a sample of the heated 

 culture upon agar with a view to the detection of any surviving micro- 

 organisms ; at the same time, if this has not before been undertaken, 

 we draw off a sample of the suspension and enumerate under the 

 microscope by the procedure described by one of us in the ' Lancet ' of 

 July 5, 1902. 



After verifying the sterility of the vaccine we now dilute with a 

 sufficiency of physiological salt solution to bring down the number of 

 staphylococci in the cubic centimetre to 2,500,000,000. Finally we add 

 lysol in sufficient quantity to bring the content of the vaccine in this 

 antiseptic to 0*25 per cent. 



In connection with boils and sycosis a vaccine made from the 

 Staphylococcus aureus ; in cases of acne a vaccine made from a mixture of 

 Staphylococcus albus and dtrem is appropriate. 



A dose of 0-5 to 1 c.c. of the vaccine made as above is a suitable 

 quantum for a first inoculation. For subsequent inoculations 1 to 2 c.c. 

 of the vaccine may be employed. 



Below are subjoined four of the more instructive of the curves which 

 we have obtained by the periodical examination of the phagocytic 

 power of the blood subsequent to inoculations of staphvlococcus 

 vaccines. 



Curve 1. The curve here in question applies to a medical man who 

 had suffered from boils almost continuously for 4 years. 



