ACTIVE IMMUNIZATION FOR THERAPEUTIC PURPOSES 659 



urethra and general therapeutic measures should be employed. It may 

 be stated that vaccines should be used routinely in all cases, as under 

 any condition the infection is likely to be prolonged and tedious. In the 

 acute stages the doses should be relatively small, about 10,000,000 cocci 

 being given every three to five days. In the subacute stages from 

 50,000,000 to 100,000,000 may be given at intervals of from five to ten 

 days. 



Vulvovaginitis of Children. Stock gonococcal vaccines have been 

 used quite extensively in the treatment of this troublesome infection. 

 On the whole, good results have been reported, although in any case 

 final judgment must be reserved until thorough bacteriologic examina- 

 tion shows whether the tissues are really free from infection or whether 

 the infection has subsided and become chronic. Smears of the secretions 

 alone are insufficient to determine whether a cure has been effected. 

 Injecting a solution of 1 : 2000 bichlorid of mercury in normal saline 

 solution into the vagina, followed by immediate centrif ugalization of the 

 washings and smears of the sediment, will frequently demonstrate the 

 presence of gonococci that will not otherwise be found. If vaccines are 

 used, a dose of from 5,000,000 to 10,000,000 every five to seven days 

 may be employed. 



RESPIRATORY DISEASES 



Rhinitis. The use of mixed stock vaccines is being advocated for 

 prophylactic immunization against recurrent attacks of acute rhinitis. 

 With Weston, I have found autogenous vaccines of some value in lessen- 

 ing the severity and hastening the recovery from the acute rhinitis of 

 scarlet fever, so potent a factor in the dissemination of that disease. In 

 chronic rhinitis an autogenous vaccine, prepared by growing cultures 

 with the care previously described, may be of distinct value, but only 

 when an underlying factor, such as a malformation or adenoids, has been 

 removed, and only when used in conjunction with efficient local treat- 

 ment. 



Bronchitis. Allen speaks very highly of the value of autogenous 

 vaccines in the treatment of acute and chronic bronchitis and broncho- 

 pneumonia of children. Various microorganisms are found in the 

 secretions, and the vaccines used are generally mixed. The usual thera- 

 peutic measures are employed simultaneously. It is claimed that vac- 

 cines lessen the discomfort and hasten recovery. 



Pertussis. A hemophilic bacillus closely resembling the influenza 

 bacillus has been ascribed by Bordet and Wollstein as the cause of pertus- 



