CHAPTER XV 



TOXINS AND ANTITOXINS (CONTINUED) 

 CONVALESCENT AND IMMUNE SERA 



Introduction. — There are a number of diseases other than diph- 

 theria in which the physician may find it desirable to use a specific 

 immune or convalescent serum for diagnosis, prophylaxis or treat- 

 ment. Among these diseases are scarlet fever and some other 

 streptocDceus infections, pneumococcus pneumonia, meningococ- 

 cus meningitis, measles, poliomyelitis, tetanus, botulism, gas 

 gangrene and tularemia. 



It is the purpose of this chapter to bring out a few important 

 immunological facts relative to each of the diseases mentioned. 



Scarlet Fever. — Scarlet fever is a toxemic and infectious dis- 

 ease which is moderately contagious. It is quite generally con- 

 ceded that Dick and Dick (1923) established a beta hemolytic 

 streptococcus as the causal agent. The disease is characterized 

 by fever, leucocytosis, angina (sore throat), a diffuse erythema 

 that can be blanched by scarlet fever antitoxin or by pooled 

 convalescent serum, desquamation, and the development of a 

 lasting immunity following recovery. 



The subject of scarlet fever is treated so extensively in a mono- 

 graph by Dochez (1924) and in all of the standard texts of 

 Pathogenic Bacteriology that only a few salient facts will be 

 mentioned in this chapter. 



The evidence which points to the hemolytic streptococcus as 

 the etiological factor may be summarized as follows : 



1. Beta hemolytic streptococci are invariably found associated 

 with the disease. 



2. Dick and Dick (1923) experimentally reproduced typical 

 cases of scarlet fever in man with pure cultures of these strepto- 

 cocci and apparently satisfied the postulates of Koch. 



3. The organisms produce a soluble toxin, when properly cul- 

 tured, that is capable of producing fever, rash, leucocytosis, 

 desquamation, and antitoxin when injected in sufficient amounts 

 into a susceptible human subject. 



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