258 MODERN BIOLOGIC THERAPEUSIS 



apply to all cases. It depends not only upon 

 the nature of the infection, but also on the in- 

 dividual susceptibility. The local reaction fol- 

 lowing the injection must also be interpreted 

 properly. Marked tenderness with induration 

 and erythema prolonged for several days is an 

 indication of excessive dosage. If new lesions 

 appear within three days after injection of the 

 vaccine, it indicates that the dose was too large. 



DOSAGE OF ACNE VACCINES 



In administering Acne Vaccine, the technic of 

 Engman has proved to be of value. Best re- 

 sults are obtained with initial doses of three 

 million. After three days, the lesions are 

 opened, gently massaged, the larger comedones 

 extracted, and moist hot compresses applied 

 twice daily. On the sixth or seventh day an in- 

 jection of 3 to 5 million is given, and the same 

 local treatment repeated for three days. After 

 this, the dosage is gradually increased to 10 mil- 

 lion. Small doses at intervals of 5 to 7 days 

 have given the best results. In some cases 

 larger doses may be tolerated by the patient and 

 are indicated ; but great care must be exercised 

 in giving increased dosage, especially as to the 



