280 MODERN BIOLOGIC THERAPEUSIS 



deaths. He reports (Military Surgeon, June, 

 1913) that the fall of temperature often of two 

 or three degrees after injection of the vaccine, 

 together with the great relief from the dis- 

 tressing symptoms, such as pain and dyspnea, 

 was very marked. 



Dosage The dosage is regulated on a sliding 

 scale. In most cases an injection of 50 million 

 is sufficient as an initial dose. All subsequent 

 doses should be increased rapidly, giving 100 

 million on the second day, 200 million on the 

 third day, etc., being guided by the clinical symp- 

 toms, including the temperature, physical signs 

 and general condition of the patient. If the 

 patient improves on the day following the pri- 

 mary injection, no vaccine is necessary on that 

 day; but if the temperature remains high, an 

 increased dose may be given at this time. 



Most cases of broncho-pneumonia are due to 

 mixed infection, the streptococcus and staphylo- 

 coccus being present as well as the pneumo- 

 coccus. Good results in these cases have been 

 obtained by using a combined vaccine, the aver- 

 age initial dose containing 50 million pneumo- 

 cocci, 25 millon streptococci and 50 million 

 staphylococci, repeated daily until the tempera- 



