THERAPY. 445 



established because the second injection causes 

 milder symptoms than the first. The phagocytic 

 power of the leucocytes is raised, because of an 

 increase in the "opsonins." The curve of the anti- 

 bodies is like that usually obtained by active immu- 

 nization with bacteria, toxins or other substances. 

 Immediately following the inoculation there is a 

 decrease even of normal antibodies. This "nega- 

 tive phase/' according to "Wright, lasts for from 

 one to several days and corresponds to a period of 

 increased susceptibility. Eussell and others have 

 not observed this period of increased susceptibility. 

 It is quickly followed by a positive phase in which 

 the antibodies and, correspondingly, the resistance, 

 increase rapidly. When very small doses are 

 administered the positive phase may be recognized 

 after twenty-four hours (Wright). Large doses 

 cause a prolonged negative phase and are to be 

 avoided. 



Following injection, "the local symptoms first Local 

 make themselves felt after an interval of two or 

 three hours. The effects then seen are the develop- 

 ment of a red blush and more or less serous exuda- 

 tion at the site of inoculation, followed by some 

 lymphangitis along the lymphatics which lead, ac- 

 cording as the vaccine has been inoculated above 

 or below the middle line of the trunk, in the direc- 

 tion of the glands of the axillae or of the groin. 

 . . . Even severe inflammation has never led on 

 to suppuration." The exudate is somewhat hem- 

 orrhagic, and the pain varies from moderate to 

 severe, but is not of long duration. With the 

 technic as recommended at present, "the constitu- 

 tional symptoms are limited to some headache and General 

 to two or three hours of real malaise. The Reaction. 



