MANUFACTURE OF VACCINES 737 



age number of the given species of bacteria ingested by the leucocytes 

 of the patient, as compared to that which the leucocytes of normal 

 blood are capable of destroying. It is usually found that immediately 

 following the injection of specific bacterial vaccine there is a " negative 

 phase" during which the leucocytes of the patient destroy a smaller 

 number of bacteria. This is followed by a "positive phase," character- 

 ized by more active phagocytosis. For practical purposes the determi- 

 nation of the opsonic index is unnecessary as the clinical reaction fol- 

 lowing the injection of a given vaccine indicates correct dosage and 

 progressive results of the treatment. 



The use of bacterial vaccines has yielded excellent results espe- 

 cially in the curative treatment of furunculosis, acne, sycosis, puerperal 

 infection, arthritis and other affections caused by pyogenic organisms, 

 and in chronic infections of the genito-urinary tract. The material 

 may be used in the form of "autogenous" or "stock" vaccines. An 

 autogenous (personal) bacterial vaccine is one prepared from a culture 

 of the specific organism isolated from the case under treatment. 

 Bacterial vaccines, prepared from stock cultures of the specific organ- 

 isms, may be manufactured and kept until needed for use. Some of 

 the more common stock bacterial vaccines represent the following 

 organisms alone or in various combinations: Strept. pyo genes, M. 

 pyo genes var. (albus, aureus and citreus), M. gonorrhoea, Bact. pertussis, 

 M. pneumonic?, and B. coli communis. 



The study of bacterial vaccines occupies a position of so much 

 importance in preventive medicine and therapeutics that many new 

 combinations of killed bacteria are being constantly added to the 

 list of experimental products. Some of these have been under ob- 

 servation for a considerable time and are recognized as possessing 

 valuable properties. 



TYPHOID FEVER. The typhoid bacterial vaccine of Wright* is 

 generally accepted as a valuable preventive against infection. For 

 prophylactic treatment, a series of three hypodermic injections 

 (500,000,000, 1,000,000,000 and 1,000,000,000) of killed typhoid 

 organisms are usually given. 



Typhoid-paratyphoid vaccine (Bacterin) is frequently used, con- 

 sisting of Bacillus typhosus 1000 million, Bacillus paratyphosus A 590 

 million, and Bacillus paratyphosus B 500 million. 



* Wright, Jour, of Hyg. 2, 1902, p. 385. 

 47 



