Am.  Jour.  Pharm. 
July,  1919. 
Lipovaccines. 
473 
LIPOVACCINES.1 
Prophylactic  inoculation  of  great  masses  of  people  against  in- 
fectious diseases,  such  as  typhoid,  cholera,  dysentery,  plague  and 
possibly  pneumonia,  has  for  years  been  an  ideal  in  the  minds  of 
many  sanitarians,  especially  those  who  have  been  in  contact  with  the 
populous  but  disease-ridden  oriental  countries  where  even  simple 
methods  of  sanitation  have  encountered  opposition.  Inoculation 
itself,  however,  has  met  so  many  practical  difficulties  that  it  has  re- 
mained largely  an  unattainable  ideal.  With  the  vaccines  heretofore 
used,  a  relatively  severe  local  and  general  reaction  followed  the  in- 
oculation; and  while  the  health  officer,  by  means  of  a -variety  of 
expedients,  might  send  home  his  first  dose  of  vaccine,  it  was  quite 
another  matter  to  induce  the  subjects  to  come  back  for  more.  Nor 
has  this  been  true  in  dealing  with  unintelligent  communities  only. 
Ferran,  so  far  back  as  1885,  inoculated  thousands  against  cholera 
in  Spain;  the  work  of  Haffkine  with  plague  in  India  is  well  known ; 
Shiga  inoculated  against  dysentery  in  Japan,  and  the  more  recent 
work  of  Lister  in  South  Africa  against  pneumonia  also  seems  suc- 
cessful. The  most  pronounced  results  have  been  obtained  with 
typhoid-paratyphoid  vaccines.  The  severity  of  the  reactions,  how- 
ever, has  been  sufficient  to  make  mass  application  unpopular  and 
therefore  impracticable  in  civilian  work. 
Perhaps  the  use  of  lipovaccines  will  do  more  to  solve  the  prob- 
lem than  any  other  factor.  Le  Moignic  and  Pinoy  were  the  first  to 
substitute  oils  for  the  physiologic  sodium  chloride  solutions  previ- 
ously used  in  making  vaccines,  and  the  advantages  of  the  change 
were  obvious.  Bacterial  toxins  and  even  endotoxins,  to  a  degree, 
are  lipotropic ;  and  the  fact  that  their  toxic  effects  are  inhibited  when 
they  are  injected  simultaneously  with  lipoids  and  lipoid-rich  tissues, 
such  as  brain  substance,  has  been  explained  on  this  basis.  The 
lipoid-oil  vehicle  of  the  vaccine  serves,  therefore,  not  only  in 
delaying  absorption  but  very  probably  in  some  directly  neutralizing 
manner.  Indeed,  Le  Moignic  and  Pinoy  found  that  they  could 
inject  three  and  four  times  the  dose  of  the  usual  saline  vaccine  at  a 
single  injection  of  the  lipovaccine  without  undue  reaction  and 
achieve  an  immunity  that  was  on  a  par  with  that  obtained  following 
repeated  inoculations  with  ordinary  vaccines.    The  fact  that  bac- 
1  Reprinted  from  Jour,  of  the  American  Med.  Assoc.,  May,  1919. 
