By immunity is meant non-susceptibility to a given disease, Immunity. or to experimental inoculation with a given bacterium or toxin. The term must be used in a relative sense, and account must always be taken of the conditions present. An animal may be readily susceptible to a disease on experimental inoculation, and yet rarely or never suffer from it naturally, because the necessary conditions of infection are not supplied in nature. That an animal possesses natural immunity can only be shown on exposing it to such conditions, this being usually most satisfactorily done in direct experiment. Further, there are various degrees of immunity, and in this connexion conditions of local or general diminished vitality play an important part in increasing the susceptibility. Animals naturally susceptible may acquire immunity, on the one hand by successfully passing through an attack of the disease, or, on the other hand, by various methods of inoculation. Two chief varieties of artificial immunity are now generally recognized, differing chiefly according to the mode of production. In the first - active immunity - a reaction or series of reactions is produced in the body of the animal, usually by injections of bacteria or their products.
The second - passive immunity - is produced by the transference of a quantity of the serum of an animal actively immunized to a fresh animal; the term is applied because there is brought into play no active change in the tissues of the second animal. The methods of active immunity have been practically applied in preventive inoculation against disease; those of passive immunity have given us serum therapeutics. The chief facts with regard to each may now be stated.
1. Active Immunity. - The key to the artificial establishment of active immunity is given by the fact long established that recovery from an attack of certain infective diseases is accompanied by protection for varying periods of time against a subsequent attack. Hence follows the idea of producing a modified attack of the disease as a means of prevention - a principle which had been previously applied in inoculation against smallpox. Immunity, however, probably results from certain substances introduced into the system during the disease rather than from the disease itself; for by properly adjusted doses of the poison (in the widest sense), immunity may result without any symptoms of the disease occurring. Of the chief methods used in producing active immunity the first is by inoculation with bacteria whose virulence has been diminished, i.e. with an "attenuated virus." Many of the earlier methods of attenuation were devised in the case of the anthrax bacillus, an organism which is, however, somewhat exceptional as regards the relative stability of its virulence. Many such methods consist, to speak generally, in growing the organism outside the body under somewhat unsuitable conditions, e.g. at higher temperatures than the optimum, in the presence of weak antiseptics, etc.
The virulence of many organisms, however, becomes diminished when they are grown on the ordinary artificial media, and the diminution is sometimes accelerated by passing a current of air over the surface of the growth. Sometimes also the virulence of a bacterium for a particular kind of animal becomes lessened on passing it through the body of one of another species. Cultures of varying degree of virulence may be obtained by such methods, and immunity can be gradually increased by inoculation with vaccines of increasing virulence. The immunity may be made to reach a very high degree by ultimately using cultures of intensified virulence, this "supervirulent" character being usually attained by the method of passage already explained. A second method is by injection of the bacterium in the dead condition, whereby immunity against the living organism may be produced. Here manifestly the dose may be easily controlled, and may be gradually increased in successive inoculations. This method has a wide application. A third method is by injections of the separated toxins of a bacterium, the resulting immunity being not only against the toxin, but, so far as present knowledge shows, also against the living organism.
In the development of toxin-immunity the doses, small at first, are gradually increased in successive inoculations; or, as in the case of very active toxins, the initial injections are made with toxin modified by heat or by the addition of various chemical substances. Immunity of the same nature can be acquired in the same way against snake and scorpion poisons, and against certain vegetable toxins, e.g. ricin, abrin, etc.
In order that the immunity may reach a high degree, either the bacterium in a very virulent state or a large dose of toxin must ultimately be used in the injections. In such cases the immunity is, to speak generally, specific, i.e. applies only to the bacterium or toxin used in its production. A certain degree of non-specific immunity or increased tissue resistance may be produced locally, e.g. in the peritoneum, by injections of non-pathogenic organisms, peptone, nucleic acid and various other substances. In these cases the immunity is without specific character, and cannot be transferred to another animal. Lastly, in a few instances one organism has an antagonistic action to another; for example, the products of B. pyocyaneus have a certain protective action against B. anthracis. This method has, however, not yielded any important practical application.
2. Passive Immunity: Anti-sera. - The development of active immunity by the above methods is essentially the result of a reactive process on the part of the cells of the body, though as yet we know little of its real nature. It is, however, also accompanied by the appearance of certain bodies in the blood serum of the animal treated, to which the name of anti-substances is given, and these have been the subject of extensive study. It is by means of them that immunity (passive) can be transferred to a fresh animal. The development of anti-substances is, however, not peculiar to bacteria, but occurs also when alien cells of various kinds, proteins, ferments, etc., are injected. In fact, organic molecules can be divided into two classes according as they give rise to anti-substances or fail to do so. Amongst the latter, the vegetable poisons of known constitution, alkaloids, glucosides, etc., are to be placed. The molecules which lead to the production of anti-substances are usually known as antigens, and each antigen has a specific combining affinity for its corresponding anti-substance, fitting it as a lock does a key. The antigens, as already indicated, may occur in bacteria, cells, etc., or they may occur free in a fluid.