692 ACTIVE IMMUNIZATION 



to an original bacteria count of about 750,000,000, is administered by 

 subcutaneous injection every other day until three or four doses have 

 been given. This vaccine is claimed to produce a better and more prompt 

 immunity response than other vaccines. It has also been used in the 

 treatment of typhoid fever by intravenous injection. 



Results. The value of the typhoid prophylactic therapy is best 

 shown in the army, where conditions are better controlled than is possible 

 in civilian life. In 1911, of a division of United States troops, about 

 20,000 men along the southern boundary, only two cases of typhoid 

 fever developed and both recovered. During this same period of time 

 49 cases were reported in the city of San Antonio, with 19 deaths. The 

 soldiers mixed freely in the city, ate of fruits and vegetables, drank of 

 the same water, and in this manner were freely exposed, although the 

 sanitary conditions in the camp were excellent. 



In 1898, during the Spanish War, there were assembled at Jackson- 

 ville, Florida, 10,759 troops, among whom there were certainly 1729 

 cases of typhoid, and including the suspected cases, this figure reached 

 2693 cases, with 248 deaths. This camp continued about as long as 

 that in 1911, the climatic conditions and water supplies being practically 

 the same, but the sanitary conditions were bad. The remarkable dif- 

 ference in the typhoid rate cannot, however, be reasonably explained by 

 perfect camp sanitation, and the results in 1911 leave no doubt as to the 

 value of antityphoid vaccination. 



Excellent results have been reported by Spooner, Hachtel and Stoner, 

 and others as to the prophylactic value of typhoid immunization in 

 hospital-training schools for nurses, insane asylums, and other public 

 institutions. 



Recommendations. In view of the satisfactory results obtained in 

 the army, typhoid vaccination is now obligatory on all members of the 

 army and navy corps. Protection of the individual by immunization 

 is the only measure of protection independent of surroundings and 

 effective under all conditions. 



Typhoid inoculation in civilian practice cannot be as wide-spread 

 or as readily performed as vaccination against smallpox, as the prophy- 

 lactic must be administered subcutaneously and more than one dose is 

 necessary. 



1. Our various State and city boards of health should endeavor to 

 educate the laity, and, if necessary, offer the prophylactic free of charge 

 in order to build up a vaccinated community as far as this is possible. 



2. Persons coming in intimate contact with typhoid patients, such 



