ESTIMATION OF THE OPSONIC POWER OF THE BLOOD 177 



cent, lysol. Lastly, it is pipetted off with a i c.c. pipette or 

 hypodermic needle (of course, sterile) into i c.c. ampoules, 

 previously sterilized by heat. 



The doses appropriate for the various organisms have been 

 given under the appropriate headings, but a few more notes may 

 be useful. In acute cases small amounts given frequently are 

 advisable, the effect, if any, on the temperature and other symp- 

 toms being watched with great care. If none are produced, an 

 increased dose may be given after twenty-four to forty-eight hours, 

 whilst if there is any beneficial effect the next injection should 

 not be given until this has shown some signs of passing off; or, 

 if the patient continues to improve, in four or five days. It 

 should be borne in mind that in acute infections, especially if 

 severe, a dose of vaccine, if too large, may make the patient 

 worse ; the first dose, therefore, should be small, and more or less 

 tentative, whereas the second may probably be larger, some 

 information having been obtained by the patient's response to the 

 first. In chronic cases the doses may be larger, and as a rule 

 I think there will be no great amount of benefit unless the 

 amount is sufficient to cause a reaction, a rise of temperature, 

 a swelling at the site of injection, or a slight exacerbation of 

 the lesion. The doses should be gradually increased, if necessary, 

 until the maximum is reached, and the intervals between each 

 should be usually seven to ten days. 



[Since the last edition of this book was published our views on 

 the opsonic index have changed considerably. It retains a place 

 as a method of diagnosis, but very few bacteriologists consider 

 it necessary or even useful in controlling the dosage and intervals 

 in vaccine-therapy. — Note to Fourth Edition.'] 



COLLECTION OF MATERIAL AT POST-MORTEM 

 EXAMINATIONS 



The saprophytic bacteria which occur in such vast numbers in 

 the skin and alimentary canal during life undergo very rapid 

 multiplication after death ; hence, in cases where bacteriological 

 examinations have to be made, the sectio should be performed as 

 soon as possible after death. 



The materials which should be examined in all cases are the 

 heart-blood, the spleen, and the liver, and the following methods 

 are to be employed : 



12 



