WRIGHT'S VACCINE TREATMENT. 189 



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

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



2. Streptococcus vaccine in 20 m. 10 m. and 5 m. 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 fre- 

 quently 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 m., 10 m. and 8 m. 



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



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

 best employed as autogenous vaccines. 



6. Typhoid vaccine in 1000 m. and 2000 m. for prophylactic inoculation. 



7. Colon vaccine in 25 m., 10 m., 5 m. Vaccines of coliform organisms 

 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 stock 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 where one may go as high as 

 2,500 or even 5,000 millions. 



In colon, streptococcus, gonococcus and acne, doses of i to 3 million 

 should be used at the beginning and then gradually increased. 



In tuberculosis Wright starts with the T. R. in dilution equivalent to 

 about i/iooo mg. of the dry tuberculin substance and this is increased to 

 about 1/600 mg. 



Wright cites two general rules to be observed in the therapy of infectious diseases. 



1. In all cases where the normal antibacterial power of the blood has been lowered, 

 immunization is indicated. 



2. Whenever the blood possesses strongly active curative powers, an increased blood 

 supply to the infected part should be attempted in order that the antibacterial elements 

 of the blood and leucocytes might display their effect. In such cases the production of 

 hyperemia is particularly of help. Similarly, massage and other such therapeutic 

 measures can be useful. 



The therapeutic value of auto-inoculation is very slight and should not be encouraged, 

 as in this way the exact dosage cannot be followed out. 



Wright has employed these vaccines in staphylo, strepto, and gonococcus infections, 



