TOXINS AND ANTITOXINS 283 



shown it may be caused by an anaerobic streptococcus first de- 

 scribed by Schottmiiller in 1910. A review of the literature indi- 

 cates that puerperal sepsis may be caused by organisms similar 

 to those responsible for "gas gangrene." When the disease is 

 caused by beta hemolytic streptococci, it is conceivable that an 

 antistreptococcus antitoxin is of value if it can opsonize the bac- 

 teria and neutralize the toxins of the particular hemolytic strep- 

 tococcus causing the trouble. In the light of our present Iviiowl- 

 edge one should not expect it to be of value in the treatment of 

 the disease when the anaerobic streptococcus is the causal agent 

 unless an antigenic relationship exists. Serum treatment of puer- 

 peral sepsis has been quite unsatisfactory, very likely for the 

 reasons given above. 



Streptococcus Septicemia. — At the present time there is no 

 satis L'jietory specific scrum therapy for streptococcus septicemia. 

 Frequent transfusions are used quite extensively with vaiying re- 

 sults. Antistreptococcus serums are of apparent value in some 

 cases. It seems that in streptococcus septicemia there is not only 

 a deficiency of antibodies but there also exists a deficient activity 

 and mobilization of the phagocytic cells of the body. Gay has 

 shown that unless the phagocytic army is mobilized and active, 

 the supplying of antibodies will be relatively ineffective. The value 

 of chemotherapy in streptococcal and other bacterial infections is 

 discussed later in this chapter. 



Immuno-Transfusion IN Septicemia. — Specific immuno-trans- 

 fusion is recommended by Brady and Crocker (1932) in the treat- 

 ment of streptococcus septicemia. Stevenson (1933) reports the 

 use of nonspecific and specific immuno-transfusions in a case of 

 hemolytic streptococcus septicemia, with satisfactory results. For 

 the nonspecific immuno-transfusion normal individuals were given 

 typhoid vaccine intravenously and put to bed for the moderate 

 chill that followed in about one hour. Seven hours later 500 c.c. of 

 a donor's blood was withdrawn, citrated, and injected into the pa- 

 tient with septicemia. This type of treatment was repeated sev- 

 eral times with beneficial results. During this period a vaccine 

 was made from streptococci isolated from the patient and a nor- 

 mal volunteer immunized. His blood was used in the final trans- 

 fusion. There was observed a shift in the Schilling count from 

 left to right after each transfusion. 



