204  Use  of  Antitoxins  and  Vaccines.      { Am"Ma°y  r'i9u arm" 
In  some  infections,  as  in  staphylococcic  infection,  accessory 
measures  are  seldom  needed,  while  in  streptococcic  infections  they 
are  nearly  always  necessary.  In  gonococcic  infections  of  the  urethra 
and  prostate,  the  mere  injection  of  vaccines  accomplishes  but  little; 
in  gonococcic  infections  of  the  joints,  however,  the  vaccine  is 
apparently  sufficient. 
We  are  indebted  to  Besredka  of  the  Pasteur  Institute  in  Paris 
for  an  improvement  upon  bacterial  vaccines  which  constitutes  a 
real  advance  in  vaccine  therapy.  As  said  above,  when  the  bacterial 
vaccine  is  injected  beneath  the  skin  a  small  quantity  of  the  protein 
is  split  up  by  natural  ferments  and  the  specific  non-poisonous  part 
thus  liberated  stimulates  the  production  of  ferments  which  con- 
tinue the  disintegration  until  the  maximum  effect  of  the  vaccine 
is  obtained. 
The  ferment  itself  is  composed  of  at  least  two  constituents;  one 
is  specific,  and  by  Ehrlich  has  been  called  amboceptor  (the  opsonin 
of  Wright  is  a  similar  antibody).  This  substance  has  the  power 
of  fixing  itself  to  the  bacteria,  thus  preparing  them  for  digestion 
by  another  substance  which  is  not  specific  but  is  always  present 
in  the  blood  of  healthy  animals,  and  because  the  latter  completes 
the  ferment  action  it  is  called  complement.  Besredka  proposed 
that  amboceptor  be  utilized  to  prepare  the  bacteria  for  the  immediate 
action  of  the  complement.  The  amboceptor  is  obtained  by  injecting 
goats  or  sheep  with  massive  doses  of  bacteria  like  those  it  is  desired 
to  sensitize.  Bacteria  thus  prepared  for  the  action  of  the  com- 
plement were  said  to  be  "  sensitized,"  and  the  suspensions  of  such 
bacteria  were  called  by  him  "  sensitized  vaccines."  The  advantage 
they  have  over  ordinary  bacterial  suspensions  is  that  they  eliminate 
the  period  during  which  the  specific  ferment  is  being  formed. 
"  Sensitized  vaccines  "  have  already  been  used  extensively  in  France 
and  also  to  a  certain  extent  in  England.  The  published  reports 
amply  attest  their  superiority. 
Antibacterial  Serums. 
The  so-called  "  therapeutic  or  antibacterial  serums "  include 
antistreptococcic,  antipneumococcic,  and  antimeningococcic  serums. 
These  are  prepared  by  the  injection  of  horses  first  with  dead  and 
then  with  living  bacteria.  In  the  case  of  antimeningococcic  serum 
injections  of  autolyzed  bacteria  are  alternated  with  the  cocci  them- 
