WHY VACCINES VARY.

Northern Advocate, 14 August 1919, Page 3

WHY VACCINES VARY.

SIR ALMROTH WRIGHT'S NEW THEORY.

Sir Almroth Wright has once again set the medical profession thinking, says the medical correspondent of "The Times." This, it would seem, is his special mission, for no matter what opinion may be formed of his views and work, it cannot be denied that as the leader of bacteriology militant he has achieved not one, but half a dozen revolutions.

The new challenge runs something afte r this fashion: —You are all using vaccines in all sorts of conditions, and sometimes you are getting good results, wonderful results, and sometimes you are getting no results at all. Why?

The answer, which the "Lancet" rightly characterises as "a notable contribution," is well worth the attention of the public at large. For we are: only at the threshold .of the prevention and treatment of disease by vaccines. In the first place, Sir Almroth begins by recalling attention to his work on blood-poisoning from wounds. That work was heralded in 1914 by the announcementit came with the force of a bombshell, and all the pieces are not yet collected, that antiseptics were useless and prevented rather than helped the cleansing and healing of wounds. The "heresy" is repeated in 1919, as follows :—

"The war has taught the. surgeon that if he provides the requisite conditions—and he does provide them when he exercises all devitalised and heavily infected tissues, and brings together the walls of the wound — the protective mechanism of the body can, without any antiseptics, deal successfully with every kind of infection."

This is unequivocal. Sir Almroth then takes this point—the -remarkable self-protective powers of the body, and also the fact, shown by typhoid inoculation, that the body can be taught, in advance of the assault upon it by bacteria, to offer special resistance to them —and frames his answer to the query, "Why do vaccines sometimes succeed and sometimes fail?"

Lest there should be any failure to undei-tand this answer, let us recall for a moment the principles upon which vaccination is used. The idea is this. If a man, ignorant of poisons, is told that upon a certain day a month hence he will be required to swallow a pint of laudumn, he will rceogn'se that 'in the absence of a mirage, sentence to death is being passed upon him. A knowledge of r;<_crs and the manne- in which tolerance to them can be devebped would, however, hav c caused him to adopt a very different view. He would have known that by taking small doses of laudanum for a day or two, and. then gradually increasing these doses he could so far develop a tolerance to the drug that when the day of his trial came he might hope to escape with his life. In other words, he would beaab e to develop a protection against the poison; as indeed is the experience of every smoker of tobacco.

Afte r a somewhat similar fashion —the-analogy must not >be pushed too far—-a. vaccine, which consists of th e poison of a germ, but not the living germ itself, prepares the whole body against the. evil day when the germ will.arrive and attack it. The germ does arrive, it makes its attack, the patient may not even fall ill.

But this kind of vaccination is not the only kind which has succeeded. Vaccines given during an illness have often been instrumental in ending that illness. This has remained more or less a mystery. Why should adding more poison to that already present help th e body to fight the poison? The explanation usually given was that the body was thereby whipped to more strenuous efforts. It was not satisfying. As well, the critics of the procedure argued, give a man suffering from Laudanum poisoning an additional dose of laudanum.

Sir Almroth Wright furnishes a new answer—one of those flashes of th e mind which seem so obvious when they have been accomplished.

"With respect to immunising response, the body has been visualised as a single and undivided unit. That is clearly erroneous. One region of the body may be making immunising response while the other is inactive."

In other words, disease begins locally, and is fought at first only in the locality in which it begins—by the advanced posts, not by the whole army. There is still time, while that battle is going on, to warn the whole army to be ready, to summon the whole army to meet the invader; as Sir Almroth puts it in scientific phraseology.

"Placing ourselves at this point of outlook, therapeutic immunisation will, it is clear, be theoretically admissable so long as there remains in the body any part which is not already making its maximum immunising response."

The regions not yet exposed to attack are warned, and are called into play to help those in distress by means of the vaccine, which is not local in its effects, but general. Consequently, w e have a clear explanation of the reason why vaccines succeed best when localised conditions — e.g., boils, are best treated, and are most apt to fail in severe general illness, and in very long standing infections.