VACCINES IN TREATMENT OF DISEASE 259 



number and development of new lesions follow- 

 ing such an injection. 



The initial dose of the combined vaccine 

 should not exceed 5 million of the acne bacilli 

 and 50 million staphylococci. Subsequent doses 

 may be increased as indicated by the clinical 

 symptoms. 



Morris and Dore after extensive use of vac- 

 cines in acne do not recommend their use as a 

 routine treatment but prefer to reserve them 

 for carefully selected cases. The cases may 

 be divided into two groups. The first consists 

 of cases characterized by deep-seated pustules 

 situated on the chest, face and back. In such 

 cases, the combined vaccine administered dur- 

 ing a period of several months is of some value. 

 The second group comprises cases in which the 

 lesions are superficial and indolent, mostly pa- 

 pules and comedones. In these, Acne Vaccine 

 gives good results in a large proportion of 

 cases. Morris and Dore concludes that : * ' Ex- 

 perience prevents us from claiming more for 

 vaccine therapy in acne than that it is a useful 

 adjunct to the ordinary forms of treatment." 



In the management of every case of acne, gen- 

 eral measures hygienic and dietetic must be 



