432 INFECTION AND RESISTANCE 



Friedberger and Mita 15 have suggested another method which 

 also depends upon very slow administration rather than division of 

 dose. In experiments upon guinea pigs they had found that sensi- 

 tized animals which, as tested by controls, would succumb to intrave- 

 nous injections of 0.01 c. c. of sheep serum per 100 grams weight 

 when the entire quantity was injected within one minute, would sur- 

 vive a similar administration of as much as 0.1 c. c. if, by means of a 

 specially constructed apparatus, the injection was made gradually, 

 extending over a period of 100 minutes. While this method offers 

 many practical difficulties to ordinary bedside application, it does 

 show that the intervals of injections by the Besredka method do 

 not need to exceed fractions of an hour or, at most, a few hours 

 in order to add materially to the safety of injection. 



There is another phase of specific therapy in which the question 

 of possible anaphylaxis must be taken into consideration, and that 

 is the treatment of patients with bacterial vaccines. As a matter of 

 fact the danger of anaphylaxis in such cases is probably very remote 

 both because of the shortness of the intervals at which these injec- 

 tions are usually made and because of the extremely small amounts 

 of protein represented by the usual dose of 100 or 200 millions of 

 bacteria. However, the possibility cannot be disregarded, especially 

 in children, and two cases were verbally described to the writer by 

 Dr. Philip Van Ingen, in which gonococcus vaccines caused immedi- 

 ate symptoms of such a character that anaphylaxis could not be ex- 

 cluded. 



Ohlmacher 16 also has described localized reactions at the place 

 of inoculation as well as swelling and tenderness at points of former 

 inoculations following bacterial vaccine injections. He has oc- 

 casionally seen slight systemic symptoms (dizziness, nausea, etc.) 

 which he explains on the basis of anaphylaxis. 



Moreover, it must be remembered that active sensitization with 

 bacterial antigens has been most regularly successful in the hands 

 of Kraus and Doerr, 17 Holobut, 18 and Kraus and Admiradzibi, 19 as 

 well as in confirmatory experiments carried out in the Stanford 

 laboratory, when repeated injections at short intervals were made, 

 rather than when, as in serum anaphylaxis, a single injection only 

 was given. This would lend an even closer analogy to the procedures 

 carried out during vaccine treatment. For instance, in the successful 

 experiments of the last-named writers ten daily injections of 1/100 

 of a slant culture of dead colon bacilli were made for the purpose of 



15 Friedberger and Mita. Deutsche med. Woch., No. 5, 1912; figures 

 taken from Versuch., 3. 



16 Ohlmacher. Jour. Med. Ees., Vol. 19, 1908, p. 113. 



17 Kraus u. Doerr. Wien. klin. Woch., No. 28, 1908. 



18 Holobut. Zeitschr. f. Immunitatsforsch., Vol. 3, 1909. 



19 Kraus u. Admiradzibi. Zeitschr. f. Immunitatsforsch., Vol. 4, 1910. 



