THE NONSPECIFIC AGENTS 31 



only the region which is actually harboring the microbe, and in the stage 

 of generalized infection it is presumably the entire body which is incited 

 to respond. And again, in localized infection we may making here some 

 reserves assume that we have only localized response. 



"Placing ourselves at this point of outlook, therapeutic immunization 

 will, it is clear, be theoretically admissible so long as there remains in the 

 body any part which is not already making its maximum immunizing 

 response. And the program of therapeutic inoculation would accord- 

 ingly consist in exploiting in the interest of the infected regions of the 

 body the immunizing responses of the regions which are uninfected. 



"Results of Vaccine Therapy 



"Keeping that now in view, let me try, very briefly, to tell you what are, 

 in my view, the results which have been achieved by applying this thera- 

 peutic method. I can do that in a very few words. 



"In every form of infection a certain quota of unequivocal successes 

 may be credited to the method, and especially successful results have been 

 obtained in furunculosis and acute inflammatory sycosis; in 'poisoned 

 wounds' meaning by that localized cellulitis set up by a streptococcus in- 

 fection; in streptococcal infections taking the form of lymphangitis, in 

 erysipelas; in tubercular adenitis, tubercular joint infections, tubercular 

 dactylitis, tubercular orchitis, and tuberculous infections of the eye, es- 

 pecially in phlyctenules of the conjunctiva; again in bronchitis, in chole- 

 cystitis, and gonorrheal rheumatism. The most dramatic and convincing 

 convincing because here no other therapeutic measures are employed as 

 adjuncts are the successes obtained in streptococcal lymphangitis, in 

 streptococcal cellulitis I am thinking of those cases which have already 

 been incised without striking benefit and in conjunctival phlyctenules. 



"When we analyze the successes and failures* of vaccine therapy the 

 following points come out quite clearly: 



"(1) Vaccine therapy is generally unsuccessful where the infection 

 as in phthisis is producing constitutional disturbance and recurring 

 pyrexia. 



"(2) Vaccine therapy is also generally unsuccessful where we have to 

 deal with unopened abscesses, or sloughing wounds with corrupt discharges. 



"(3) In long-standing infections vaccine therapy is much less success- 

 ful than in recent infections. 



"To see what auxiliary measures should be applied in these cases, I 

 must take you back for a moment to the region of general principles. . . . 



*I here, as clear thinking exacts, exclude from the failures of vaccine 

 therapy the failures of that preventive inoculation against individual infections 

 to which vaccine therapy is the usual precursor. The efficacy of such prophy- 

 lactic procedure is a question apart. But I may usefully point out to you 

 that the superior credit which attaches to antityphoid inoculation, and preventive 

 inoculation against infective diseases generally, as compared with preventive 

 inoculation against what I may call individual infections, is probably attributable 

 to the fact that, in the case where we are dealing with an infective disease, the 

 external circumstances are as favorable to success as they are in the case of 

 inoculation against "individual infections" unfavorable. 



