After a proper diagnosis has been made, the patient’s opsonic index
taken, and the appropriate vaccine prepared, the patient receives his
initial injection of several hundred millions more or less of the heated
bacteria, and his opsonic index is watched. A short time after the
inoculation is made the opsonic index falls lower than it was previous
to the injection. This Wright has named the “negative phase.” Sooner or
later, from a few hours to several days, the opsonic index rises above
the starting-point. This is called the “positive phase.” The amount of
the opsonins in the blood remains stationary for a variable length of
time, and then diminishes. As soon as their diminution is noted, a
second injection of the vaccine is given, which is followed by a
negative phase, but less pronounced than before. Soon the positive phase
comes on, reaching a higher level than previously. Thus the injections
are repeated from time to time according to the opsonic index of the
patient’s blood, and the positive phase gradually attains a higher and
higher level, until it may be as high as or considerably higher than
that of a normal person. In other words, if the vaccinations are
properly given, “never during a negative phase,” and as a result the
patient’s tissues are stimulated to an increased production of the
opsonins, phagocytosis is increased, the invading bacteria are disposed
of, and the patient recovers from his infection. The proper handling of
patients according to this method requires the greatest attention to
details of technique for obtaining the opsonic index, preparing the
vaccine, and the administration of the proper dose at the proper time.
It is too early to know the ultimate results that may be expected from
the use of the vaccines, but from personal observation, conversation
with other workers, and numerous reports, most of which are incomplete,
it seems reasonable to believe that for localized bacterial infections
much may be accomplished. Especially does this seem probable for acne,
furunculosis, sycosis, abscesses, and lupus, adenitis, and other similar
tubercular infections.
In incipient pulmonary tuberculosis encouraging results have been
obtained where minute doses of new tuberculin, 1/1000 of a milligramme
more or less, have been given, which seemingly show that Koch’s original
observations were well grounded in fact.
Something has been accomplished in those diseases in which the bacterial
infection is in the blood stream.
After a careful consideration of the literature of the entire subject I
believe we should recognize the new therapy as an experimental procedure
of much promise, but until more extended observations have been made the
use of the vaccines should not be looked upon as a settled method of
treatment.