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JAMA. 1937;109(18):1444-1445. doi:10.1001/jama.1937.02780440034009.
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The criteria for the use of vaccines in the treatment of rheumatism are not yet clearly defined. It is hence necessary to examine the theoretical considerations supporting the use of vaccines. Their use demands the assumption that rheumatism—at least those types treated by vaccination—is due primarily to bacterial infection. Of necessity, therefore, an etiology or virus of noninfectious nature cannot now be considered in relation to vaccines. Adherents of such etiologic theories must thus be opposed to vaccine therapy as a rational procedure.

There are several possible modes of action of the bacterial proteins which presumably are the primary and active constituents of all vaccines. The first is by stimulation of immune body formation. If the immunization intended by the administration of vaccines is specific in nature, it can be effective only if the bacteria which are already present in the body and are causing the disease are not in


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