VACCINE THERAPY 299 



cine treatment, but it must be expected that many cases will fail to 

 improve. On the whole, surgical treatment is more satisfactory. 



Eczema. The recent studies of this disease have shown that many 

 cases are the result of hypersusceptibility to proteins, usually those 

 contained in food. Granted that such hypersusceptibility is demon- 

 strable, treatment is in the form of immunization to the particular 

 protein concerned. Such immunization is similar to that employed 

 in hay fever and has been commented on in the chapter on hyper- 

 susceptibility (page 231). Kolmer states that the prolonged admin- 

 istration of an autogenous bacterial vaccine composed of staphylococci 

 procured from the scales or serous exudate has occasionally aided in 

 the treatment of obstinate cases of eczema. 



Ringworm. Strickler has recently employed a vaccine made of 

 several strains of the fungus and is of the opinion that the method has 

 some value in obstinate cases. 



Other Skin Diseases. Vaccination has been employed with a vari- 

 able degree of success in the different forms of acne, sycosis, scrofulo- 

 derma, impetigo and certain forms of erythema. 



DISEASES OF THE RESPIRATORY TRACT 



Rhinitis. Vaccination against acute rhinitis has been largely 

 prophylactic in nature, and the results of these vaccinations have been 

 in a general way favorable. The exact cause of this disease has not 

 been finally proven, but the work of Foster indicates rather strongly 

 that the agent is a filterable virus. The prophylactic vaccines, however, 

 have been mixed stock vaccines of a variety of bacteria, and it seems 

 probable to us that any success obtained upon this basis is probably 

 non-specific. Coates is of the opinion that if acute rhinitis is treated 

 early with vaccines there is likely to be improvement. The course of 

 acute rhinitis is so variable that statistical results are open to some 

 question. In chronic rhinitis it is maintained that autogenous vaccines 

 are of value. It must be understood, however, that contributory causes, 

 such as adenoids, enlarged tonsils, polyps and nasal deformities must 

 be removed. So much benefit accrues from ,the correcting of the 

 contributory causes that the beneficial effects of vaccination probably 

 depend in certain part upon the personal equation of the observer. 



Ozena. The cause of this disease is at present a matter of con- 

 siderable dispute, and the value of vaccination is undecided. The vac- 

 cines that have been employed are usually made from the bacillus 

 ozenae fetidae of Perez. Horn claims that this organism is similar to 

 the bacillus bronchisepticus and has made polyvalent stock vaccines 

 which he claims are highly successful. Friel reports excellent results 

 from the intravenous administration of sensitized living vaccine of 

 Friedlander bacillus. Ersner has had disappointing results. While im- 

 provement may occur in a certain percentage of cases, McKenzie found 

 a marked tendency to relapse following the cessation of treatment. 



Asthma. As with eczema, the recent investigations of hyper- 

 susceptibility have placed the study of asthma upon an entirely new 



