﻿430 STRONG. 



they apparently are in a condition in which they are capable of being 

 much more easily absorbed than when they are injected bound to the 

 bacterial cells. However this may be, with the cholera organism the 

 local reactions are unquestionably less severe after inoculation with 

 our prophylactic than from the injection of the living spirillum. I have 

 received inoculations by both methods, and the suffering caused by the 

 living organisms is much more marked. 



SIZE OF THE DOSE AND STANDARDIZATION OF THE PROPHYLACTIC. 



Most observers, in discussing the size of the dose in inoculations against 

 cholera, agree that the immunity obtained is in proportion to the amount 

 of the immunizing substances injected. This was shown very conclu- 

 sively by my early experiments which have been referred to in this article. 

 However, Friedberger and Moreschi combat this view and, as has been 

 mentioned, believe that as high an immunity can be obtained from 

 the intravenous injection of very small amounts of the cholera spirillum 

 as from the subcutaneous injection of much larger ones. I have not 

 had any experience with the intravenous inoculation of the cholera 

 organism in such small quantities as Friedberger and Moreschi have 

 employed. The experiments of Fischera and of Meinicke, Jaffe and 

 Flemming do not confirm Friedberger and Moresehi's results, as has been 

 mentioned in the discussion of the literature; moreover, they believe 

 that with such small quantities of the organism the very favorable 

 results obtained may have depended more upon the individual variation 

 of the animal in regard to susceptibility and immunity than upon the 

 amount injected. In relation to the size of the dose inoculated it 

 may be recalled that Wright, 26 in his inoculations against typhoid fever 

 in the English army, attempted to inject each individual with almost 

 exactly the same number of killed typhoid bacilli. In order to ac- 

 complish this purpose he employed a twenty-four, hour broth culture of 

 a known and proved strain of Bacillus typhosus and enumerated the 

 number of bacteria in this culture by the ingenious blood counting- 

 method which he devised. 



Leishman and Harrison, 27 in further pursuing the question of typhoid 

 inoculation among the English troops, also attempted to standardize 

 their vaccine by the procediire advanced by Wright. However, they 

 found that in spite of all precautions, errors in the broth cultures of 

 from 50 to 100 per cent in counts of the same films were by no means 

 uncommon. Leishman and Harrison also spent some time in their 

 efforts accurately to standardize their typhoid prophylactic (consisting 

 of the killed typhoid organisms,) by estimating in addition with the 

 assistance of Martin, the weight of the dried bacterial bodies in a 



28 Brit. Med. Journ. (1900), 1, 122, and Lancet (1902), 2, 11. 

 27 J. of Eyg. (1905), 5, 380. 



