Memoranda concerning vaccination in the prophylaxis of typhoid fever.

  • Magill, William S., 1866-
Date:
[1912]
Catalogue details

Licence: Public Domain Mark

Credit: Memoranda concerning vaccination in the prophylaxis of typhoid fever. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    utilized: Solution A—in which the emul- sion of polyvalent typhoid bacilli has been carried in the incubator for twenty-four hours only, and solution B—in which the same emulsion was carried in the incubator for forty-eight hours. For producing a typhoid immunity with Vincent four injections are given to each patient every eight to ten days, the first injection being one-fourth of a c.c. of the twenty-four hours' incubated emulsion, and the second dose three-fourths of a c.c. of the same emulsion. The third dose con- tains one c.c. of the forty-eight hour incu- bated emulsion and the fourth dose con- tains two c.c. of this latter emulsion. It is claimed for Vincent's method of provoking immunity that a better grade of intensely organic resistance is obtained with less, practically no, discomfort of the patients treated. Returning now to the German and Eng- lish vaccines, their method of use is the same and the process of vaccination con- sists in the administration of three injec- tions to each person in whom it is desired to provoke a typhoid immunity. The vac- cines prepared in Germany, England or this country are standardized as previously described and to these solutions a dose of lysol, or trikresol, to the amount of about one-fourth of one per cent, is utilized for the preservation of the sterility of this vac- cine matter after that sterility of the standardized solutions of the typhoid ba- cilli has once been produced at the labor- atory. After producing the vaccine solutions, diluting them to obtain the proper stand- ard desired, these solutions are heated care- fully in a water bath to about 53 degrees centigrade (Leishman), or 55 to 57 degrees centigrde (German and American Labor- atory Uses). It is preferable not to allow the heat of these vaccine solutions to go higher than 53 degrees and it is found that the heat- ing of these solutions of living typhoid bacilli for one, to one and one-half hours, at 53 degrees centigrade produces their complete sterilization. It has been pointed out that without such heating the mere addition of the small quantities of antisep- tic previously noted would produce the sterilization of that fluid after a few days time, but the experimental work of Leish- man would indicate that the heating to 53 degrees centigrade in no way lessens the immunity production power of the vaccine and is, therefore, retained as an additional safeguard for sterility. After sterilization and then the addition of antiseptic the vaccine of standards A and B are carefully sealed in glass ampul- lae, in which packages, protected from the light and kept relatively cool, it has been found that the power of immunity produc- tion, and therefore, practical utility of the vaccine is retained for at least three months. The production of immunity with these vaccines is obtained by three injections to the patient. The first injection should be a dose of 500,000,000 typhoid bacilli, fol- lowed ten days later by a second injection of 1,000,000,000 typhoid bacilli, and this followed eight to ten days later by a fur- ther dose of 1,000,000,000 typhoid bacilli. The English authority is inclined to con- sider the first two injections sufficient to provoke a satisfactory immunity, at the same time considering that three or even four injections would be of advantage to the degree of immunity resulting. The use of vaccine in troops involves, as far as possible, the injection of three doses. It is to be recalled that this method of protection from typhoid fever by such vac- cines dates back already fifteen years. The results of the extensive vaccination in the English army since that period have come from more and more extensive utilization of such vaccination; and results of this method of vaccination in Germany are available from the colonial troops for the last seven years; and results for more than two years' utilization in the United States are also available. Speaking in general terms, it can be said that this vaccine method is without dan- ger; that carried out as at present, it in- volves very slight inconvenience for any of the persons so inoculated and practically in no case does it result in any symptoms of severity. The reports of the use of this vaccine with the troops actually in active duty, show conclusively that the large vac- cine treatment does not interfere to any extent with any of the men on active duty.