PRODUCTION OF ANTIPNEUMOCOCCIC SERUM 543 



about the same increase was noted in the last three bleedings when 

 compared with the intermediate three. 



The Production of Therapeutic Serum 



REASONS FOR AND AGAINST THE USE OF UNCONCENTRATED 

 SERUM 



Until relatively recent times, the feasibility of concentrating 

 and refining the specific serum used in the treatment of lobar pneu- 

 monia found scant recognition. Avery, Chickering, Cole, and 

 Dochez 36 in 1917 believed that the disadvantages of the concen- 

 trated product were such as to render it of little practical value. 

 In a later publication, Cole (1929), 265 although recognizing that 

 treatment of pneumonia with large doses of whole serum was not 

 ideal, questioned seriously the advisability of using concentrated 

 preparations. Cole objected to the methods used for standardiza- 

 tion and doubted whether the small doses of concentrated anti- 

 body recommended would have any effect on the mortality rate. He 

 concluded that unless very large doses of concentrated serum were 

 employed or unless more accurate methods of standardization were 

 adopted, it would be wiser to continue to treat cases of Type I 

 pneumonia with potent, whole serum in large doses. 



Sickles (1929) 1278 offered a comparison of the protective titers 

 of unconcentrated and concentrated serums. The results led to the 

 impression that unconcentrated serums were superior to concen- 

 trated products because of zonal phenomena in the action of the 

 concentrates, and because, in her experience, the potencies of the 

 two kinds of preparations were not essentially different. Much of 

 the objection to concentrated serum voiced by Sickles was based 

 on unsatisfactory results attending the methods of standardiza- 

 tion employed. In 1932, Wadsworth, 1463 in discussing the question, 

 stated that there were no clinical data to indicate that refined 

 products were more effective in the treatment of pneumonia than 

 whole serum of the highest potency and, furthermore, that before 



