24 Mr Noon, Therapeutic Inoculation for 



Therapeutic Inoculation for Generalised Bacterial Infections. 



By L. Noon, B.C., F.B.C.S., John Lucas Walker Student of 



Pathology in the University of Cambridge. [Communicated by 

 Professor Woodhead.] 



[Bead 23 l^ovember 1908.] 



It will be conceded that recovery from a generalised bacterial 

 infection depends on the defence-mechanism of the patient being 

 called into action. To an invasion of bacteria Nature replies with 

 a reaction which has for its object the increase of the natural 

 defences. Since, however, this reaction often fails, it is the 

 business of the medical man to ask whether Art may not improve 

 on Nature in this respect. If the natural reaction is delayed or 

 incomplete, that is, if it is not the best, the most efficient reaction 

 of which the patient is capable, we had better seek to improve 

 matters by the use of an appropriate stimulus. 



The following experiments are directed to shew that the 

 presence of large numbers of infecting organisms throughout the 

 system is not generally a sufficient stimulus to set the protective 

 mechanism of the tissues into action at once ; while on the other 

 hand a subcutaneous injection of a suitable dose of the killed* 

 bacteria provides a generally efficient stimulus. 



The organism used was the B. pseudotuberculosis rodentium. 

 When this was injected into the peritoneal cavity of a rabbit or 

 guinea-pig there followed a general peritonitis, associated with the 

 formation of miliary abscesses in the liver and spleen, and in 

 guinea-pigs also in the lungs. The abdominal lymphatic glands, 

 as also frequently the mediastinal glands, become caseous. At 

 death the blood was found to give a pure culture of the organism 

 in every case. The bacillus is nearly related to that of plague 

 {B. pestis). The disease is nearly always fatal in guinea-pigs ; of 

 rabbits, which received an infecting dose of -^^ of a 24 hours' agar 

 slope culture, nearly one half died. 



The disease is therefore a severe one, and widely spread in the 

 body of the experimental animal. The natural defensive reaction 

 against this disease consists first of an increase of opsonine. 

 Later on an agglutinin appears, but no bactericidal or antitoxic 

 substances can be demonstrated satisfactorily. 



I traced the evolution of opsonic resistance in rabbits which 

 had been infected as described above, and I found at once that a 

 period of inertia follows on the infection. During this period the 



* The killed organisms referred to in this paper were subjected to a temperature 

 of 60° C. for half au hour. 



