VACCINES IN TREATMENT OF DISEASE 245 



The definition of the degree of reaction which 

 indicates the optimum dose of vaccine has oc- 

 casioned much discussion, some arguing that the 

 slightest reaction is the optimum, others that 

 more marked reactions are advisable. Experi- 

 ence teaches that, in general, severe reactions 

 are to be avoided in all cases. Each disease 

 presents special problems in this respect and, in 

 any disease, the individual case must be con- 

 sidered. In general, if there is any question as 

 to the strict localization of the process, any re- 

 action in excess of a moderate local redness or 

 slight febrile reaction is to be regarded as a 

 warning that the dose should be decreased or at 

 least not increased. 



SURGICAL MEASURES 



The inoculation of bacterial vaccines for the 

 treatment of local infections, like other proced- 

 ures in medicine, has been employed under con- 

 ditions not contemplated by those who devised 

 it, to the neglect of older and approved methods 

 of treatment. The attempt by inoculation of 

 vaccines to promote the healing of an acute ab- 

 scess, in which incision and evacuation of pus 

 is necessary, shows a total misapprehension of 



