286 APPLIED IMMUNOLOGY 



puration seems to be markedly curtailed and convales- 

 cence proportionately shortened. On the other hand, 

 tuberculin in carefully selected cases of ear and mas- 

 toid tuberculosis has proved of great benefit. 



Rhinitis and Sinusitis. — The bacterial flora of the 

 nasal passages and associated sinuses differ little from 

 those of the auditory apparatus. The results follow- 

 ing the use of bacterins, however, are much better, 

 due probably to the greater vascularity of the parts 

 affected. Indeed, in suppurative sinusitis the em- 

 ployment of autogenous bacterins, aside from any 

 surgical indication, should constitute the sheet-anchor 

 in treatment (Fig. 56) . The chief offending bacteria 

 are Streptococci, Pneumococci and Micrococci catar- 

 rhalis. The dosage frequently must be increased over 

 the average. 



Laryngitis and Tracheitis, — The following bacteria 

 are commonly demonstrable: 3/,. catarrhalis, D. 

 pneumonice. Streptococcus pyogenes. Staphylococcus, 

 M, paratetragenus, B. diphtherice, B, influenzcB and 

 B, tuberculosis. Occasionally, excellent results have 

 attended the use of bacterins in these affections, par- 

 ticularly with the M, catarrhalis, Pneumococcus, 

 Streptococcus and Staphylococcus, 



Diphtheria. — In recent years active immunization 

 against diphtheria has been studied extensively by 

 several observers. If those who are naturally immune^ 



