TOXINS AND ANTITOXINS 285 



were responsible for 66.8 and Type III for 13.0 per cent of 454 

 cases of pneiiniococcus lobar pneumonia studied by them. 



History of Serum Treatment of Pneumonia. — The history of 

 the serum treatment of pneumococcus pneumonia extends back 

 to the beginning of the last decade of the nineteenth century. Ac- 

 cording to Cole and Dochez (1915), the first to apply pneumo- 

 coccus immune serum from animals in the treatment of lobar 

 pneumonia were G. and F. Klemperer (1891). They used serum 

 from highly immunized rabbits in the treatment of 18 cases and 

 observed improvement in some and failures in others. Foa and 

 Scabia (1892) and Jansson (1892) also reported some favorable 

 results from the use of immune rabbit serum in lobar pneumonia. 

 Washbourne (1897) and Payne (1897) employed immune sera 

 from horses and donkeys respectively and noted improvement in 

 some of their cases. Eyre and Washbourne (1899) reported that 

 serum sent them by Payne was effective against four strains of 

 pneumococei but ineffective against a fifth which they had. While 

 tliere were a number of reports favorable to the serum treatment 

 of lobar pneumonia, there w^ere a great many that were definitely 

 unfavorable. 



Discovery of Types. — It was not until Neufeld and Handel 

 (1910) and Dochez and Gillespie (1913) had demonstrated defi- 

 nite types of the pneumococcus, and that immune serum is type 

 specific, that any light was thrown upon the failures of serum 

 treatment of lobar pneumonia. Neufeld and Handel called atten- 

 tion to the importance of larger doses of serum in the treatment 

 than had been used previously. They also introduced the mouse 

 protection test as a method of determining the potency of im- 

 mune serum. 



Discovery of Soluble Spp:cific Substance. — In 1917 two other 

 important contributions to our knowledge of the etiological agent 

 were made. Dochez and Avery discovered the soluble specific sub- 

 stances and as previously mentioned Olmstead reported that T.ypc 

 IV is made up of a number of groups rather than single strains 

 of pneumococei. The soluble specific substances of Types I- 

 XXXII are discussed by Brown* (1939). 



Concentration of Antibody. — Efforts had been made by Gay 

 as early as 1915 to increase the protective property of specific im- 



♦Brown, R. : Chemical and Immunologrical Studies of Pneumococcus Soluble 

 Specific Substances of Types I-XXXII. J. Immunol. 37: 445, 1939. 



