INOCULATIONS OF BACTERIAL VACCINES. 567 



treated, and were given 653 injections of combined personal and gonococ- 

 cus (stock or personal) vaccine. The results from this series were 

 not any better than were those from a stock gonococcus vaccine alone. 



My results in gonorrheal arthritis have been excellent. I have treated 

 18 cases and have reports of 12 more that were treated with vaccine 

 sent out by me, in all of which recovery has been prompt and complete. 

 I recently have learned of three cases in which the outcome has not 

 been satisfactory : two showing only moderate improvement after several 

 injections, and one showing no change after a single injection. 



The results of bacterial vaccination in chronic suppurative otitis 

 media have been very satisfactory. I have treated, or prepared the 

 vaccine for treatment of 51 cases. Three of these could not be followed. 

 In 37, the discharge stopped after from one to four injections of a 

 personal vaccine. In 11, the discharge did not stop after a prolonged 

 course of injection. In sis the discharge recurred. In the case of one 

 little girl, the discharge from the ear ceased after several injections. 

 The otologist in charge of the case reported that, to judge from an exam- 

 ination of the ear he considered the inflammatory process at an end. 

 However, the little girl developed a meningitis a few months later and 

 died. At the autopsy the case proved to be purulent meningitis due to 

 extension from necrotic bone in the affected ear. The auditory canal was 

 clean, and there was little evidence of inflammation in the lining of the 

 middle ear. A few of the cases are cited below. 



One case, suppurative otitis media, right ear, for several years. Left ear, 

 for two weeks; furuneulosis, left external auditory canal. Vaccine made from the 

 discharge from each ear and the two mixed. Two injections, with interval of 

 one week. Complete recovery in both ears, and the ears remain well 6 months 

 later. 



Another case, suppurative otitis media, left ear, for two weeks. Discharge 

 stopped four days after first injection and ear remains well six months later. 



A third case, with a left otitis media that had recurred several times at 

 intervals of some months, received a single injection of a personal vaccine and 

 the discharge ceased the next day. The patient left the city, and I understood 

 that the discharge began again some time later. As the first dose is always 

 a small one, I would not expect recovery in a long standing case from a single 

 injection. 



A fourth case, of suppurative otitis media with furuneulosis of the external 

 auditory canal, cleared up slowly under a personal vaccine and finally the dis- 

 charge stopped and the patient expressed herself as feeling much better in 

 general health than she had been previously. However, the purulent discharge 

 from the ear has since recurred. 



I have had an opportunity to treat four cases of p3'orrhcea alveolaris 

 with personal vaccine. Two cleared up entirely after a few injections, 

 while the other two showed no apparent improvement after long series of 

 injections. 



A few practical points on dosage, vaccines, and injections seem worthy 



