32 PROTEIN THERAPY 



"Nonspecific Immunization 



"In the foreground stands the question of nonspecific immunization. 

 That immunization is always strictly specific counts as an article of faith; 

 and it passes as axiomatic that microbic infections can be warded off only 

 by working with homologous vaccines; and that we must in every case 

 before employing a vaccine therapeutically, make sure that the patient is 

 harboring the corresponding microbes. I confess to having shared the con- 

 viction that immunization is always strictly specific. Twenty years ago, 

 when it was alleged, before the Indian Plague Commission, that anti- 

 plague inoculation had cured eczema, gonorrhea, and other miscellaneous 

 infections, I thought the matter undeserving of examination. I took 

 the same view when it was reported in connection with antityphoid inocu- 

 lation that it rendered the patients much less susceptible to malaria. Again, 

 seven years ago, when applying pneumococcus inoculations as a preventive 

 against pneumonia in the Transvaal mines, I nourished exactly the same 

 prejudices. But here the statistical results which were obtained in the 

 Premier Mine demonstrated that the pneumococcus inoculations had, in 

 addition to bringing down the mortality from pneumonia by 85 per cent, 

 reduced also the mortality from 'other diseases' by 50 per cent. From that 

 on we had to take up into our categories the fact that inoculation produces 

 in addition to 'direct' also 'collateral' immunization. This once recognized, 

 presumptive evidence of collateral immunization began gradually to filter 

 into our minds. Among, I suppose, many thousands of patients treated 

 by vaccine therapy in private and in hospital, it happened every now and 

 then that a patient was treated with a vaccine which did not correspond 

 with his infection, and that that patient indubitably benefited. Again, 

 it was not an uncommon experience for the subjects of a very chronic in- 

 fection (such as pyorrhea) who were treated first by a stock vaccine, and 

 afterwards with an auto-vaccine, to assert that they derived more benefit 

 from, and to ask to be put back upon treatment by the stock vaccine. 



"From such cases hints are conveyed to us that there may exist a use- 

 ful sphere of application for collateral immunization; and that such sphere 

 may, perhaps, be found in those cases where the infection is of very long 

 standing, and where the patient has become very sensitive to, and has 

 probably come very near the end of his tether in the matter of immunizing 

 response to, the particular species or strain of microbe with which he is 

 infected. It will, with regard to such patients, be remembered that they 

 constitute the third of those three classes of cases to which I referred to 

 at the ouset of this lecture as very intractable to vaccine therapy. 



"We are, however, here considering primarily the question of principle; 

 and in connection with this what is of fundamental importance is : that 

 we should discard the confident dogmatic belief that immunization must 

 be strictly specific, and that we should in every case of failure endeavor to 

 make our immunization more and more strictly specific. We should instead 

 proceed upon the principle that the best vaccine to employ will always be 

 the vaccine which gives on trial the best immunizing response against 

 the microbe we propose to combat. 



"I would point out that this would almost certainly not involve any 

 revolutionary change in the accepted practice in either serum therapy or 



