VACCINES IN TREATMENT OF DISEASE 287 



tance of bringing this infective process rapidly 

 under control with vaccine treatment can be 

 readily appreciated. The important pathogenic 

 bacteria usually found in acute otitis media are 

 the streptococcus, staphylococcus and, at times, 

 the pneumococcus. In treating this condition, a 

 combined vaccine containing these microorgan- 

 isms is being extensively employed by many 

 otologists. The initial dose of this vaccine con- 

 tains 50 million pneumococci, 25 million strep- 

 tococci and 50 million staphylococci ; subsequent 

 doses, containing multiples of this dose, are 

 given at 3 to 5-day intervals according to clin- 

 ical indications. If the vaccine is given early, 

 the ear-drum may often be saved ; but if there is 

 much bulging of the drum, it should be lanced. 

 Where the ear-drum is punctured, it will be 

 found that the discharge will often dry up in 

 much less time if a vaccine is used. 



Bacterial examinations of the pus in the early 

 stages of suppurative otitis media show that, in 

 a large majority of cases, the streptococcus is 

 the primary infecting microorganism. After 

 rupture of the ear-drum, contamination soon 

 takes place and staphylococci are found and, at 

 times, the bacillus pyocyaneous. In treating 



