246 MODERN BIOLOGIC THERAPEUSIS 



the principles of therapeutic inoculation and, 

 besides, is wasteful of the time and energy of 

 the patient. Chronic metastatic infections aris- 

 ing from some primary suppurative focus call 

 first for surgical treatment of the primary le- 

 sion, if possible; and, later, the use of vaccines 

 may be considered. The vaccine treatment of 

 suppurating sinuses has been widely advocated 

 and may prove of benefit, but first of all the 

 physician should put into practice the old surgi- 

 cal maxim that when a sinus fails to heal, it is 

 well to ascertain whether there is not some for- 

 eign body at the other end. 



INDICATIONS FOR THERAPEUTIC INOCULATION 



Infectious processes in general are suitable 

 for vaccine treatment (1) if they are localized; 

 (2) if they are more or less chronic; and (3) if 

 adequate surgical measures have been applied. 

 Any departure from this definition makes the 

 indications for vaccine treatment less clear, 

 though it is conceded that many instances are 

 daily met with that make the trained immu- 

 nologist feel justified in extending his efforts 

 beyond these limits along experimental lines. 



Almost from the beginning of bacterial ther- 



