Methods of Making the Vaccine 273 



suppurations), tubercle bacilli, etc., etc., ought to be appropriate. 

 And, indeed, for them the treatment is highly recommended, and in 

 many cases remarkable success is claimed. 



Remembering that the reactions of immunity are specific, it is 

 imperative that the essential organism of the lesion be found and 

 cultivated, and cultures of that organism used in the treatment. 

 So important is this that Wright insists that only "autogenous 

 vaccines" — that is, vaccines made of cultures of bacteria cultivated 

 from the very lesion to be treated — ^be used. This somewhat hmits 

 the usefulness of the method for the rank and file of practitioners 

 can scarcely be supposed to have the knowledge, apparatus, or time 

 required for carrying out the technic, nor can all patients afford 

 to patronize the laboratory man. Commercial manufacturers are 

 therefore justified in the preparation and sale of what are known as 

 "stock vaccines" that can "be tried in Ueu of autogenous vaccines, 

 though in checking up the results note should always be taken of 

 the fact that "autogenous" or "stock" vaccines were used. 



In spite of the general principles laid down above, there are re- 

 ports and observations to show that the theoretical considerations 

 may be faulty and that in some cases the method of treating by 

 ■ vaccination may be beneficial in acute maladies, even when the 

 condition to be treated is toxic. It will be necessary, however, to 

 secure much more evidence with regard to the employment of the 

 method in such cases before it can be recommended as sound 

 practice. 



Should a case of appropriate kind, when investigated, yield more 

 than one species of micro-organism, of such kind as to make it un- 

 certain which is responsible for the injury done, both should be 

 cultivated, two vaccines made and mixed, and both infections 

 simultaneously antagonized'. 



The Method of Making the Vaccine. — A pure culture of the 

 necessary micro-organisms is obtained from the lesion to be treated, 

 and cultivated on agar-agar. 



One pint "Blake bottles," pint or quart white glass whisky flasks, or other 

 good sized bottles with large flat sides, are selected and washed. Into each 

 enough melted agar-agar is filled to spread out over one of the flat surfaces to a 

 thickness of about i centimeter, after which a cotton plug is placed in the 

 mouth of the bottle, and it and its contents are sterilized in the autoclave. Upon 

 removal, after sterilization, the bottle is laid on its side so as to distribute the 

 agar-agar and permit it to solidify over the greatest surface, without flowing 

 ipto the neck and touching the cotton stopper. To the agar-agar culture of the 

 micro-organism to be used, about lo cc. of sterile 0.85 per cent, sodium chloride 

 solution is added, the culture mass being detached with a platinum loop and 

 thoroughly mixed with the fluid. When the agar-agar is firm, each bottle 

 receives by means of a carefully sterilized pipet, about i cc. of the culture 

 suspension which is thoroughly distributed over the entire flat surface of the 

 agar-agar by tilting the bottle this way and that until it has been completely 

 covered. The bottles are then placed in the incubating oven, lying upon the 

 side so as to permit the bacteria to vegetate undisturbed upon the moist flat 

 surface of the medium. After 24 hours, the growth having matured, the bottles 

 are removed and about 10 cc. of sterile distilled water containing 0.85 per cent. 

 18 



