ANTIRABIC VACCINE 457 



before inoculation are dilution (Hogyes), emulsification with i per cent, 

 phenol (Fermi), and drying at very low temperature (Harris). 



By treatment with antirabic vaccine after the bite of a rabid animal, 

 immunity is usually established before the incubation period of the dis- 

 ease is concluded and rabies is thus prevented. Each dose should be 

 emulsified as few hours as possible before the injection and it is therefore 

 advisable that treatment should be carried out at no great distance from 

 the place of propagation of the virus. 



3. BY INJECTION or KILLED ORGANISMS. This class is composed 

 almost entirely of bacterins. It is the safest method of immunization 

 against cholera, typhoid and plague. In the Pasteur treatment of hydro- 

 phobia the first injection of the dried spinal cord probably contains the 

 killed virus. 



A bacterin is a suspension of killed bacteria in isotonic saline solution 

 and nearly always has a preservative added such as 0.9 per cent, tri-cresol 

 or 0.5 per cent, phenol. 



An "autogenous" vaccine is one made from the bacterial strain iso- 

 lated from the patient, while a " stock" vaccine is one made from labora- 

 tory cultures. Whenever practicable autogenous should be made, in some 

 cases being absolutely necessary. 



CHOLERA VACCINE. Prepared from killed cholera vibrios. Cholera 

 vaccine has been used in India as a prophylactic with in part favorable 

 results. 



GONOCOCCUS VACCINE. Made from the Micrococcus gonorrhceae. 

 Clinical experience has presented no clear evidence of the value of gono- 

 coccal vaccine in affections of the mucous surfaces. As a prophylactic 

 against metastatic complications it may have some value. Many ob- 

 servers believe that these vaccines are useful in arthritis. The value of 

 vaccines in gonococcal pelvic lesions is not clearly determined. They are 

 of little if any value in gonococcal sepsis or in gonococcemia. 



MENINGOCOCCUS VACCINE. Made from the Diplococcus intracellu- 

 laris meningitidis of Weichselbaum. It has been used in a limited number 

 of cases with apparent success for the prevention of epidemic cerebrospinal 

 meningitis. 



PERTUSSIS BACILLUS VACCINE. Made from the bacillus of whooping- 

 cough, isola ed by Bordet and Gengou and proved the causative agent of 

 the disease by Mallory. The evidence indicates that it is of value both 

 for prevention and treatment, although eminent authorities state that the 

 results have not been very satisfactory. 



PLAGUE BACILLUS VACCINE. Made from the Bacillus pestis. Vaccine 

 has been used for the prevention of plague with results justifying its use 

 but owing to the acute nature of the disease time is not allowed for the 

 development of active immunity after actual infection. No practical 

 application therefore has been made of vaccine treatment in plague. 



