468 SEROTHERAPY 



and from erysipelas, etc. Streptococci are known to be the cause 

 of various septic conditions and to complicate scarlet fever, and other 

 contagious diseases. In cases of localized sepsis, a vaccine made from the 

 organisms causing the septic condition in the particular cases is frequently 

 useful. For this purpose an autogenous streptococcus vaccine may be 

 useful in abscess, the septic complications of scarlet fever, such as otitis, etc. 

 The use of vaccines in cases of chronic deforming arthritis has met with 

 some success, but it is a mistake to rely largely on them. Stock vaccines, 

 being less directly related to the cause of the disease, afford less prospect 

 of success than autogenous. 



Streptococcus vaccines have been suggested for the prevention of 

 scarlet fever and for the treatment of scarlet fever, puerperal fever, acute 

 rheumatism, ulcerative endocarditis, etc., but clinical experience affords 

 no sufficient evidence of their value in these conditions. There is reason 

 to believe that in conditions of general sepsis large doses of vaccines may 

 be directly harmful. 



ERYSIPELAS AND PRODIGIOSUS TOXINS (COLEY) . This preparation is 

 practically a mixed bacterial vaccine made from strains of Streptococcus 

 pyogenes isolated from cases of erysipelas and from bacillus prodigiosus. 

 Its use has been advised in cases of inoperable sarcoma. This remedy 

 is said to have produced cures in 10 per cent, of the total number of cases 

 treated. It is worthy of trial in cases in which radium or the Roentgen 

 ray is unsuccessful. It is given by hypodermic injection partly into 

 the tumor or its near neighborhood and partly at a distance to secure 

 the benefit of both local and systemic effect. A reaction consisting of 

 chill and rise of temperature is expected to follow the injections until 

 tolerance becomes established. Dose, 0.05 to 0.5 mil (1-8 minims). 



B. PASSIVE IMMUNIZATION 



i. ANTITOXIC IMMUNITY. Rickets and Dick state 8 factors as being 

 of importance in antitoxic therapy: 



1. The concentration of the antitoxin injected. 



2. Its freedom from contamination and adventitious toxins. 



3. The time of its administration. 



4. The quantity injected. 



5. The degree of affinity between toxin and antitoxin. 



6. The degree of affinity between toxin and tissue cells. 



7. Amount of toxin which may be bound without fatal issue of which 

 the vital importance of the organs involved and their recuperative powers 

 are factors. 



8. The location of the toxin in the body, i.e., its accessibility for the 

 antitoxin. 



For the neutralization of the circulating toxin, a simple equivalent 



