Report on the employment of vaccine therapy in gynecology and obstetrics / by J. Whitridge Williams, Edwin B. Cragin and Franklin S. Newell.

  • John Whitridge Williams
Date:
1910
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Licence: In copyright

Credit: Report on the employment of vaccine therapy in gynecology and obstetrics / by J. Whitridge Williams, Edwin B. Cragin and Franklin S. Newell. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    m: REPORT ON THE EMPL(3VmeM' OF VACCINE THERAPY IN GYNE- COLOGY A*p OBSTETRICS1 By J. WHITRIDGE WILLIAMS, M. D., EDWIN B. CRAGIN, M. D., and FRANKLIN S. NEWELL, M. D. BEFORE beginning its report, your committee desires to express its con- viction that its members were unfortu- nately selected, as none of us has worked upon the scientific side of the subject, and one of us, at least, has had no experience in the practical employment of vaccine therapy. For this reason we are unable to express an authoritative opinion as to its merits derived from personal experience, and are therefore obliged to base our report upon a critical study of the literature of the subject. With this object in view, Dr. Cragin reviewed the publi- cations dealing with gonorrhoeal infections, Dr. Newell those upon infections of the urinary tract and of the internal genitalia, and Dr. Williams those upon puerperal infection and the more general aspects of the entire subject. The report therefore represents the joint work of the three members of the committee and is concurred in by each of them. It is unneces- sary to state that the subject was approached with an open mind and that our judgment, as far as possible, is unprejudiced and objective. After a few general remarks concerning opsonins and vaccines, we shall consider the use of the latter in the treatment of the follow- ing conditions: i. Gonorrhoeal infections, including vulvo- vaginitis in little girls. 2. Infections of the urinary tract. 3. Inflammatory conditions of the internal genitalia. 4. Puerperal infections, and finally we shall summarize our conclusions in a few sentences. Following the ingenious work of Metchni- koff, which began in 1865, it has become rec- ognized as a well established fact that the leu- coctytes and other cells take up into their in- terior, foreign bodies and bacteria, which then undergo various changes which may eventually result in their destruction. The process is known as phagocytosis, and it is apparent that if all the bacteria concerned in the production 1 Read before the American Gynecological of a disease could be destroyed in this way the process must come to an end. This view was promptly accepted, particu- larly in France, and, with various modifica- tions and amplifications, became the basis for the cellular theory of immunity. In Germany on the other hand, the establishment of im- munizing processes was attributed to the presence or development of certain substances in the blood serum or tissue juices, independent rf the leucocytes, and has led to the develop- ment of the humoral theory of insanity. For many years the differences between the supporters of the two doctrines were appar- ently irreconcilable; and it was not until Sir Almroth Wright enunciated his views concern- ing opsonins and vaccine therapy that either side frankly admitted that each theory was bas- ed upon accurate observations and was entitled to careful consideration. Wright’s publication directed particular attention to the practical application of the doctrines of immunity, and since his lectures in this country in 1907 opsonic or vaccine therapy has been a very live issue. For many years it has been known that one of the first responses to infection is an increase in the number of leucocytes — leucocytosis. In localized infections the process is practically limited to the infected area, around which the leucocytes form a wall of varying thickness, which serves partly as a means of removing the bacteria, but more particularly as a filter which tends to prevent their spreading into the rest of the organism. In abscess formation there is an extensive migration of leuco- cytes to the affected area, and at first they take up large numbers of bacteria, but later, as the result of insufficient nutrition and possibly also of certain products of the bacteria them- selves, they begin to break down when the tryptic ferment contained in them causes still further liquifaction of the tissues and gives rise to a typical abscess. Metchnikoff, Wright, and others pointed out ociety,, Washington, D. C-, May 4, 1910.