HISTORIC 621 



tient's own bacteria, should be used whenever possible, especially in 

 the vaccine treatment of disease. To be successful, vaccine therapy 

 demands that the bacteria be as little changed as possible. Before 

 they are killed, the bacteria should be endowed with as many of the 

 potencies as possible with which they maintain themselves in the body. 

 As .these potencies do not remain unchanged during artificial life, as 

 the loss of capsules, loss of virulence, etc., it is advisable to secure the 

 organism causing the infection as quickly as possible and prepare a 

 vaccine without undue delay. 



Variants may occur among cultures of the same species, and the 

 injection of one strain may not protect against another, as shown by 

 Neufeld for the pneumococcus. In the use of an autogenous vaccine 

 this risk of using an alien species or a different strain is reduced to a 

 minimum. 



In some cases the difficulty of securing and of identifying the in- 

 fective agent may be so great that much time is lost in preparing auto- 

 genous vaccines, as, for instance, in gonorrhea! and tuberculous in- 

 fections, and in such cases it may be necessary to use a stock vaccine. 



In protective immunization stock vaccines are used, as, for instance, 

 in the preparation of typhoid vaccine. In certain instances, as in 

 gonococcus and tuberculous infections, stock vaccines possess but 

 slightly inferior therapeutic value as compared with autogenous vaccines, 

 not to mention the delay and difficulty in cultivating and preparing 

 autogenous vaccines. In many other infections, as with the Bacillus 

 coli and streptococci, stock vaccines possess little or no value. 



The wholesale manufacture of various bacterial vaccines and their 

 indiscriminate use have brought disappointment to many. Rational 

 and scientific vaccine therapy does not consist in the administration of 

 ready-made, uncertain, and oftentimes hit or miss mixtures, recently 

 so widely exploited. Especially is this true in the use of vaccines for 

 therapeutic purposes. The bacteriotherapeutist must possess sufficient 

 skill to enable him to make bacteriologic diagnoses, prepare autogenous 

 vaccines, and skilfully guard their administration. In most instances 

 these requirements are fulfilled by cooperation between the clinician 

 and bacteriologist, or, better, by one who is especially trained in vaccine 

 therapy. 



The Negative Phase. As has been stated in a previous chapter, 

 certain local, constitutional, and focal disturbances may follow the 

 injection of a bacterial vaccine. The first or local symptoms are not in- 

 frequently due to an excess of preservative in the fluid or to the presence 



