HUNTOON AND HUTCHISON 923 



solution has caused the organisms present to become phagocytized. This phenomenon 

 also occurs in cases of cerebrospinal meningitis treated with anti-meningococcic 

 serum. 



The blood of monkeys suffering from pneumonia, when mixed with pneumococcus 

 antibody solution, is definitely bactericidal in vitro, whereas the blood alone or the 

 antibody solution alone does not have this effect. Anti-pneumococcus serum added 

 to normal rabbit's blood shows this same efifect.' 



It is probable that the therapeutic result obtained with the various antibacterial 

 sera is due to a summation of the effects of the various antibodies present. 



The use of antibacterial sera as therapeutic agents presupposes an accurate diag- 

 nosis of the infecting organisms. Bacteriological diagnosis, however, can be carried to 

 an extreme, as in the case of pneumococcus infections where the delay in waiting for 

 an accurate typing of the organism may render the use of any serum of doubtful value. 

 The successful use of antibacterial sera now rests not so much on the question of 

 laboratory production of adequate serum, but upon their clinical use in a proper man- 

 ner, taking into consideration the time factor and the question of specificity. 



ANTI-ANTHRAX SERUM 



Anti-anthrax serum was probably the first antibacterial serum to prove of cura- 

 tive value in the treatment of infectious disease. First developed by Marchoux (1895) 

 in France and in the same year by Sclavo in Italy and later by Sobernheim (1897) in 

 Germany, the serum was widely used in both human and veterinary medicine in 

 Europe and South America with excellent results. 



Preparation of the first potent serum in the United States is credited to the Bureau of 

 Animal Industry of the United States Department of Agriculture, and for a time was sup- 

 plied to the medical profession by the Bureau until it came to be supplied by several bio- 

 logical laboratories. The production of this serum has been recently summarized by Kelser,^ 

 as follows: 



"Animals used for the production of the serum are first immunized by either the simul- 

 taneous or Pasteur method. Two weeks after such treatment each serum animal is given 

 twice the amount of vaccine it received in the immunization treatment. This is usually 2 cc. 

 of Pasteur No. 2 vaccine or 2 cc. of spore vaccine of Pasteur No. 2 virulence. After the lapse 

 of one week 4.CC of the vaccine are given and this followed, after a further period of one week, 

 with 10 cc. of vaccine. One week following such injection the first dose of living, virulent 

 culture is given. The amount inoculated is one-hundredth of the amount of growth from a 

 24-hour agar culture that can be picked up in the loop portion of a standard platinum loop. 

 Injections of virulent culture are then repeated at weekly intervals. For the second dose i 

 loopful of culture is administered." The process is then continued in a series of gradually in- 

 creasing doses until a high immunity is established, as shown by the presence and increase in 

 specific antibodies — precipitins, agglutinins, and amboceptors. 



Acquired immunity to anthrax is not permanent. Recovery from the infection 

 apparently depends upon phagocytosis. This was first emphasized by Metchnikoff, 

 and it was shown by Wright that opsonins in the serum, because of their influence on 

 phagocytosis, are of value in artificial or passive immunity. According to Kolmer, 



' Bull, C. G.: personal communication. 



^KeheT,R. A.: Manual of Veterinary Bacteriotogy. 1927. 



