156 PROTEIN THERAPY 



that in every case of uncomplicated typhoid fever, bacteriotherapy 

 should be tried. 



Biedl and Eggreth also gave their experiences with the vaccine 

 treatment of typhoid fever. Biedl treated a series of 22 cases of 

 severe typhoid fever in the beginning of the second week; the 

 blood culture was positive in all of these. Of this number 2 are 

 excluded. Both were men with high fever, status typhosus, and 

 recurring epistaxis, the last nose-bleed occurring one day before in 

 each case. Two hours after injection of the vaccine there occurred 

 in each patient an uncontrollable hemorrhage from the nose which 

 led to death. Of the remaining 20 cases, 11 received Vincent's vac- 

 cine (typhoid bacilli killed with ether), first 100 million, later 250 

 million to 300 million in 2 c.c. of salt solution, and 9 were treated 

 with Besredka's vaccine intravenously (sensitized living typhoid 

 bacilli) in doses of 250 million to 300 million in 2 c.c. of salt solu- 

 tion. The end result was as follows: Of the cases treated with Vin- 

 cent's vaccine 3 died; 2 received subcutaneous injections and died 

 fourteen and eighteen days respectively after the injection; 1 treated 

 intravenously, after an initial favorable response, died in the third 

 week from severe bronchopneumonia and heart weakness. Evi- 

 dently none of these deaths were due to the vaccine. The remaining 

 8 patients recovered. All of the patients treated with Besredka's 

 vaccine recovered. Biedl's impressions were decidedly favorable. 

 After intravenous injection the temperature rose in one to two or three 

 hours from 39 to 40 C. (102.2 to 104 F.), in one case even to 42 

 C. (107.6 F.), followed in twelve to eighteen hours by a critical fall of 

 temperature to normal. No signs of collapse were observed; indeed, 

 in two cases the injection was made when the patients were in a state 

 of collapse with a pulse which could not be counted. Within three 

 hours the temperature rose, the pulse became much fuller with a rate 

 of 100 per minute. Following crisis the patients felt much better. The 

 patients treated with Besredka's vaccine remained afebrile. Some of 

 the other patients had slight evening elevations of temperature; in 

 none above 38 C. (100.4 F.). Eggreth treated a series of 43 cases of 

 typhoid with a single intravenous injection of 0.5 to 1.0 c.c. of Bes- 

 redka's vaccine. Subcutaneous injections had produced no result. 

 In 34 cases of Eggreth's series a critical fall of temperature followed 

 within three to twelve hours after the injection, frequently with pro- 

 fuse sweating and marked relief of headache and delirium. Of these 

 patients 31 remained afebrile; the remaining 3 developed fever after 

 twelve, fourteen, and fifteen days, due respectively to endocarditis, 

 to bilateral purulent parotitis, and to suppurative osteoperiostitis. 

 The majority of the patients received the injection between the sev- 

 enth and sixteenth day of the disease. In a group of 8 cases in the 

 fourth and fifth week of the disease, suffering with broncho- or pleuro- 

 pneumonia, the injection was ineffective. The forty -third case died 



