492 Chapter XV 



persons treated with the serum were already infected when they 

 were vaccinated. 



The Belgian observer points out, further, the frequency of secon- 

 dary accidents which were produced in the persons vaccinated at 

 Glasgow. Van Ermengem himself went through the ordeal after 

 being injected with 10 c.c. of serum as a protective measure and this 

 gave occasion to several critics to attack the Pasteur Institute. This 

 is how Van Ermengem himself puts the matter. " The accidents after 

 [515] the immunising injections... were very numerous, they were observed 

 33 times in 72 cases. Sometimes they were even fairly serious, to the 

 point of causing great suffering to the patient and of disquieting 

 those around them. We could describe them from thorough know- 

 ledge, since we experienced them, but they scarcely differ from those 

 which are observed from time to time after the injection of anti- 

 diphtheria serum, and, like them, they disappear without leaving the 

 least trace" (Lc. p. 18). 



In spite of these accidents and the necessity of renewing fre- 

 quently (every ten or fifteen days) the protective injections of serum, 

 their use is quite advisable in certain circumstances. They may render 

 great service on board infected vessels or in lazarettos (as in the case 

 which occurred at Frioul after the arrival at Marseilles of Arab 

 stokers suffering from plague), in docks, warehouses, and stores where 

 contaminated merchandise is found. They should also be employed 

 to vaccinate those coming into immediate contact with plague cases in 

 hospitals and in private houses. In a word, vaccinations by serum, 

 owing to their power of conferring a very rapid immunity, should be 

 practised wherever there is more or less immediate and imminent 

 danger. Under these conditions they are of very great service in 

 localising the disease. 



The methods of vaccination against plague that have been 

 employed up to the present may undoubtedly be improved. Calmette 

 and Salimbeni (I.e.) have already published the results of experi- 

 ments on animals undertaken with the object of studying the effect 

 of a combined method of vaccination with antiplague serum and 

 killed cultures of the plague bacillus. But even in their present form 

 the methods used for protecting individuals against this disease de- 

 serve to be regarded as conferring great benefits on humanity. 



XL Vaccinations against tetanus. Tetanus unlike plague is 

 not a contagious disease, nor is it capable of becoming epidemic. 



