754 GENERAL THEEAPEUTIC MEASUKES . 



liition. The vaccines may be used against any given infec- 

 tion by injecting subcutaneously small doses of the killed 

 bacteria of the same species as that causing the infection. 

 Thus in the case of staphylococcus infection one must know 

 by examination of pus from the infection what variety of 

 staphylococcus is causing the trouble and use the killed germ 

 of that same variety of staphylococcus in order to get the 

 best results. This treatment is based on the fact that the in- 

 jections of the dead bacilli and their toxins stimulate the 

 formation of antibodies in the serum of the patient — more 

 particularly opsonins — and probably bacteriolysins and ag- 

 glutinins as well. These antibodies further act by enhancing 

 phagocytosis or the power that the leucocytes have to enclose 

 and destroy bacteria — apparently by some action on the 

 bacteria. 



The antitoxins and antisera already contain antibodies, 

 which are immediately imparted to the patient on their 

 injection and so confer a temporary and passive immunity. 

 The vaccines, on the contrary, act to stimulate the cells of the 

 patient to produce antibodies and tend to confer an active 

 and permanent immunity. Acute general infections com- 

 monly counterindicate the use of vaccines, since in them 

 there is already enough toxin in the blood (causing fever 

 and other symptoms) to enable the patient to produce his 

 own antibodies and so to recover. But some systemic in- 

 fections have been successfully treated with vaccines, as puer- 

 peral infection, pyemia and septicemia. Local infections 

 are more amenable to vaccine therapy, but treatment should 

 be begun early before a mixed infection occurs and before the 

 part becomes surrounded by an impermeable barrier of 

 pyogenic membrane or bacteria. Thus staphylococcus infec- 

 tion, causing boils, acne and local suppurations; pneumococ- 

 cus infection, producing empyema, cystitis, etc ; colon bacil- 

 lus infection, inducing cystitis and other local infections, 

 have been apparently cured by injections of vaccines. Sir 

 A. E. Wright, of London, who has introduced the vaccine 

 treatment of infections to the medical profession, believes 

 that the treatment should be guided by the opsonic index. 

 This means practically the comparison of the power of 

 leucocytes to invest bacteria in the serum of the patient, with 



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