VACCINE THERAPY 301 



treatment. Chronic conjunctivitis, due to the Morax-Axenfeld diplo- 

 bacillus, is said to respond very well to vaccine treatment. In acute 

 pneumococcus and gonococcus conjunctivitis, especially with ulcer, 

 Allen advises early and vigorous vaccine therapy and reports good 

 results. It is also stated that ophthalmia neonatorum sometimes im- 

 proves rapidly under vaccine treatment. In none of these conditions, 

 however, is it wise to neglect other forms of treatment. 



DISEASES OF THE ALIMENTARY CANAL 



Typhoid Fever. Prophylactic vaccination has unquestioned value 

 in the prevention of typhoid fever (page 285). Specific therapeutic 

 vaccination has been the subject of experiment since the work of 

 Fraenkel in 1893. The vaccines employed have been usually killed 

 organisms either untreated or sensitized, administered either subcu- 

 taneously or intravenously. Certain authors have also reported the use 

 of living organisms, but this method has not been adopted. Gay, in his 

 book, " Typhoid Fever," reports the following summary of results 

 obtained by various methods : 



SUMMARY OF RESULTS OBTAINED BY RECENT OBSERVERS (1913-1917) IN THE TREAT- 

 MENT OF TYPHOID FEVER BY VACCINES ADMINISTERED IN VARIOUS WAYS. 



nK<, ., Total Estimates Bene- Mortal- 

 Observers cases basedon fited ity 



Untreated vaccine subcutaneously .... 30 1001 512 46% 14-5% 



Sensitized vaccine subcutaneously .... 14 593 239 69% &.o% 



Untreated vaccine intravenously 22 501 233 62% 13.0% 



Sensitized vaccine intravenously 12 487 316 85% 11.0% 



It is usually stated that typhoid fever has a mortality of about 10 per 

 cent., although in the American Civil War it exceeded 35 per cent, and 

 in the Franco-Prussian, Spanish-American and Boer Wars it ranged 

 between 8 and 14 per cent. The severity of epidemics varies consid- 

 erably, but at the best there is little in the way of encouragement to be 

 found in the table given above. The basis upon which improvement 

 is estimated varies considerably with the different investigators and 

 the figures are " distinctly affected by subjective influences." Gay has 

 employed a sensitized vaccine administered intravenously and his re- 

 sults in ninety -eight cases are summarized as follows : 



SUMMARY OF RESULTS IN NINETY-EIGHT CASES OF TYPHOID TREATED BY INTRA- 

 VENOUS INJECTION OF SENSITIZED VACCINE SEDIMENT. 



No. 



of 



cases 



Aborted 33 



Benefited 32 



Unaffected ... 33 



The most significant figures in this table refer to those cases which 

 were aborted. Careful study of various epidemics fails to show any 

 instance where such a large percentage of the cases have aborted, and 

 it therefore seems probable that the vaccination had some distinct value. 



