INFLAMMATION 245 



In 31 cases of cellulitis 17 healed without surgical interference. Schu- 

 bert, on the other hand, tried turpentine injections in 80 surgical 

 cases of all kinds, but his results were not satisfactory; Wederhake 

 and Chiaudano have also given the method a trial, the latter with 

 success in mastitis. 



On old chronic inflammation and sluggish ulcers much more can 

 be expected and a number of favorable reports have been published. 

 Gow, for instance, treated an old sluggish ulcer with intravenous in- 

 jection of streptococci, using a dosage of 100 million, with good re- 

 sults. In this case the reaction was delayed considerably as com- 

 pared to the reaction that follows typhoid or colon injection. The 

 pulse rate showed some change after 4 hours but the febrile rise did 

 not begin until about 10 hours after the injection. There was some 

 nausea and a headache which began twelve hours after the injection 

 and persisted for 36 hours. There was practically no leukocytic re- 

 sponse. 



Zalewski and Miiller have also reported on the treatment of old 

 ulcers and more recent wounds with milk injections (aolan) and ob- 

 tained very satisfactory results. 



Heterovaccination has found many adherents among French clini- 

 cians, and in a recent discussion of the Societe de Chirurgie at Paris 

 the treatment (especially by the method of Pierre Delbet) , particularly 

 of carbuncles and similar surgical conditions, was taken up. Pierre 

 Delbet combines the Pasteur method of attenuated cultures with the 

 modern method of killed cultures. He found it possible by this 

 means to inject a considerably larger dose, several billions of micro- 

 organisms, at one time. Despite the massive dose, he has never ob- 

 served any reaction analogous to that described by Wright as the 

 negative phase, which Delbet thinks is the result of an excessive 

 initial dose. On the contrary, certain toxic reactions were observed, 

 often very violent, and despite their intensity, these were found to 

 constitute a good omen. In the process of aging, the toxicity of the 

 culture is probably attenuated though not entirely destroyed. After 

 some attempts, Delbet fixed on 4 c.c., representing about thirteen 

 billions of organisms, as a safe and effective dose. The vaccine is, 

 naturally, a stock vaccine of streptococcus, staphylococcus and Bacillus 

 pyocyaneus (the last in great abundance: eight billions). Delbet be- 

 lieves it unnecessary to use the specific micoorganism and, like 

 Wright, he has not only abandoned autogenous vaccines, but he even 

 questions whether better results are not obtained with a vaccine pre- 

 pared from cultures of a micoorganism other than that which is 

 the causative agent in a given case. The method has been employed 

 since 1913, since which time no case of carbuncle in Delbet's service 

 has been treated by surgical incision ; boils, lymphangitis and erysipe- 

 las also respond very promptly to this treatment. 



Renaud has used typhoid vaccines in the treatment of phlegmons, 



