ACTIVE IMMUNIZATION FOR THERAPEUTIC PURPOSES 705 



lesions, being careful to secure pus that has not been contaminated by 

 the skin. Stock vaccines may .be used, although autogenous vaccines 

 are likely to yield better results. In view of the frequency of intestinal 

 disorders among persons suffering with acne, Strickler, Schamberg, and I 1 

 have studied the possible influence of Bacillus coli communis and com- 

 munior by means of complement-fixation tests, and found that the sera 

 of a large percentage of persons suffering with acne yielded positive 

 reactions. On the basis of these results I have been incorporating in 

 the vaccine one or more strains of Bacillus coli isolated from the patient's 

 feces; this modification has appeared to increase the efficacy of the 

 vaccine. It is well to administer a mixed vaccine of the straphylococcus, 

 acne bacillus, and colon bacillus, especially if the lesions are pustular. 

 It is highly essential that other forms of treatment be instituted while 

 vaccines are being tried, as the treatment is usually prolonged. Ex- 

 ceptionally, however, a brilliant result may be observed after a few injec- 

 tions. I generally prepare a mixed vaccine of 10,000,000 acne bacilli 

 to each 200,000,000 cocci and 200,000,000 Bacillus coli per 1 c.c. of 

 vaccine. The first few doses consist of 0.5 c.c., and later this amount 

 may be increased to 1 c.c. per dose. Doses are given every five to seven 

 days, or just when retrogression is observed to occur. It may be neces- 

 sary to use large doses, and in any case the treatment is prolonged over 

 many weeks and months. Most cases will show improvement, but few 

 are absolutely cured by a single series of injections. 



Eczema. The prolonged administration of an autogenous vaccine 

 of staphylococci secured from the scales of serous exudate of eczema 

 have occasionaly aided in the treatment of obstinate cases. 



Impetigo and Ecthyma. The administration of a stock vaccine of 

 Staphylococcus albus arid streptococci or, preferably, of the cocci iso- 

 lated from the pustules of impetigo contagiosa and ecthyma may be of 

 considerable value in the treatment of infections tending to pursue a 

 chronic course. Likewise the administration of an autogenous vaccine 

 in impetigo herpetiformis may be of aid in the treatment of this fre- 

 quently fatal infection in puerperal women. 



Dermatitis Venenata. The most common forms of dermatitis due 

 to poisonous plants are those caused by poison ivy or oak (Rhus 

 toxicodendron) , and of sumach or dogwood (Rhus venenata). Cer- 

 tain persons are susceptible to a poisonous principle of these plants 

 and develop a dermatitis after being in contact with them. This form 

 of dermatitis is characterized by urticarial lesions and is regarded as an 



1 Jour. Cutan. Dis., March, 1916. 

 45 



