272 PHARMACEITTICAL BACTERIOLOGY 



2. There is no negative phase (opsonic) as in the use of the ordinary 

 bacterins. The negative phase (represented by aggravation of symptoms 

 and reduction in phagocytosis) following the use of the old bacterins is due 

 to the fact that the bacteria take up specific antibodies (amboceptors) 

 from the blood of the patient. 



3. As compared with the ordinary bacterins, the local reaction (pain, 

 congestion, erythema, etc.) are greatly reduced, and the general or sys- 

 temic reaction (fever, headache, etc.) is practically eliminated. 



The work on sensitized bacterins is recent and much of the research 

 which led to the present perfection of these preparations must be credited 

 to Besredka, Ehrlich, Metchnikoff, Gay, Theobald Smith, Gordo, Meyer 

 and Babes. Sero-bacterins have been extensively tried out during the 

 world war, in nearly all of the armies, particularly the trivalent typho- 

 sero-bacterin. As the result of the use of this remedial agent typhoid 

 fever has become non-existent in the army, once the deadhest foe. The 

 U.S. army statistics show that the typhoid case rate has fallen from 3.03 

 per thousand in 1909 to 0.009 per thousand in 1914 (or a reduction of 

 98 per cent.); and the mortality rate feU from 0.28 per thousand in 1909 

 to o in 1913. Certainly a convincing showing. 



The following are the more important sero-bacterins now in use. 



Acneic. Autogenous or polyvalent stock preparation. Used in 

 acute as well as in chronic cases. 



Asiatic Cholera. — Univalent. For preventive immunization. 



Bacillus coli. — ^Univalent, autogenous, or polyvalent (strains). In 

 fistula, local infections, catarrhal jaundice. 



Influenza. — Polyvalent. In influenza, catarrh, colds. Prophylactic. 



Gonococcic. — In chronic cases. 



Meningococcic. — Preventive immunization. 



Pertussic. — Bacillus pertussis. Preventive and as a cure. 



Plague. — Active and rapid immunization. 



Pneumococcic. — ^Univalent and polyvalent. 



Pyorrheic. — Polyvalent. In bacterial pyorrhea. 



Staphylococcic. — Autogenous and polyvalent. Treatment. 



Streptococcic. — Treatment of erysipelas, infections, abscesses. 



Typhoid. — Univalent and trivalent. Immunization and treatment. 



8. Tuberculins 



The tuberculins are of special interest as they give great promise in the 

 successful treatment of tuberculosis. The different kinds have their 

 special use. Their manufacture is briefly outUned as follows: 



A. Tuberculin Old (T. O.). — ^This is the original Koch tuberculin or 

 Koch lymph and is a concentrated bouillon culture of the tubercle bacillus, 



