ANTI-VENENE THERAPEUTICS. 421 
ANTI-VENENE THERAPEUTICS. 
The following extract from an article by Charles J. 
Martin, M.B., D.Sc., F.R.S., Director of the Lister Bacterio- 
logical Institute of London, and Major George Lamb, M.D., 
I.M.S., in ‘A System of Medicine,” will no doubt prove of 
considerable interest to medical men. It is as follows :— 
“Calmette considers that Io c.c. of the Lille serum is sufficient 
in most cases of snake bite; but that if the treatment is 
delayed, or if the snake is a Cobra or a Krait, 30 c.c. should be 
used. He recommends that the injection should be given sub- 
cutaneously unless symptoms are already present, in which case an 
intravenous injection of Io or 20 c.c. is required. For reasons which 
will appear below we are convinced that these small quantities are 
quite sufficient in the case of the Cobra, against which the Lille 
serum is practically anti-toxic. In ordex to arrive at an accurate 
therapeutic dose of an anti-venomous serum, three factors must 
be determined: (1) the neutralizing power of the serum, that is 
to say the exact amount of serum which can neutralize a given 
amount of venom ; (2) the amount of poison which a snake can 
inject ; (3) the quantity of venom, the injection of which a man 
can survive. 
“Two c.c. of the Lille serum are stated to have the power of 
neutralizing I mgrm. of dried Cobra venom, and the serum issued 
by the Pasteur Institute of India is double this strength. If 
this is expressed in terms of the number of fatal doses for a 
guinea-pig of 8 grms. which can be neutralized by 1 c.c of serum, 
a comparison may be drawn between the relative potency of 
anti-venom and the anti-toxins for diphtheria and tetanus. 
Expressed in this way, I c.c. of the Indian serum neutralizes only 
10 minimal fatal doses for a guinea-pig of standard weight. On 
the other hand, one in every four horses will produce a diphtheria 
anti-toxin, I c.c. of which, when tested under the same conditions, 
will neutralize 100,000 minimal fatal doses of toxin, or if im- 
munized against tetanus will furnish tetanus anti-toxin, I c.c. 
of which will neutralize 200,000 minimal fatal doses. It will be 
seen at once that, compared with these anti-toxins, anti-venene 
is very weak. 
“We have thought it advisable to lay stress upon the real 
anti-toxic value of anti-venoms, because we think the point has 
been very imperfectly realized. 
