XIV, 1 Lantin: Treatment of Typhoid Fever 23 
Biedl, Eggerth, Sladek and Kotlowski, Boral, Holler, Lowy, 
Luksch, and Wilhelm and Myer. 
Variety of sensitized typhoid vaccine. — So far as I am aware, 
there are four kinds of this type of vaccine; namely, (a) 
Ichikawa’s living attenuated sensitized vaccine, (6) Besred- 
ka’s(l) living sensitized vaccine, (c) Gay’s (9) sediment vaccine, 
and (d) sensitized killed vaccine. 
Dosage. — The dose administered intravenously varies accord- 
ing to the kind of vaccine. Thus, of Besredka’s vaccine there 
have been used from 100 to 300 millions; Ichikawa’s vaccine, 
from 200 to 300 millions; Gay’s vaccine, from 0.2 to 0.4 milli- 
gram (150 to 300 millions). The dosage of killed sensitized 
vaccine is from 50 to 800 millions as indicated by Jobling;(i7) 
70 to 300 millions, by Dithom and Schultz; (6) and equal parts 
of typhoid and paratyphoid bacilli (500 millions) is the amount 
employed by Robertson. (40) I have employed a dosage of from 
250 to 1,000 millions of killed sensitized typhoid bacteria in- 
travenously, increasing the doses every three or four days ac- 
cording to the case. 
Contraindications. — According to eminent writers on the sub- 
ject, weakness of the heart, presence of pneumonia, and intesti- 
nal haemorrhage are contraindications for vaccine treatment. 
Thus Sladek and Kotlowski (46) believe that it increases peris- 
talsis of the intestines, with subsequent danger of haemorrhage 
and perforation. My experience leads me to believe that vaccine 
therapy is as yet of very limited applicability, and I do not feel 
that I am in a position to confirm or controvert their observa- 
tions. However, I have employed this treatment in all condi- 
tions, except in cases of intestinal hsemorrhage, and so far there 
have been no untoward effects that could be attributed directly 
to the treatment. 
This series comprises fifty-one cases of typhoid admitted 
during the height of the epidemic, of which thirty cases were 
subjected to intravenous injection of polyvalent sensitized 
typhoid vaccine, while twenty-one cases were used as controls. 
The clinical grouping of cases given vaccine treatment intra- 
venously is shown in Table III. 
Table III . — Condition of patients 
Severe and toxic 
Severe and nontoxic 
Mild 
before treatment. 
Cases. 
9 
15 
6 
Total 
30 
