ANTI-VENENE THERAPEUTICS. 423 
namely, about 350 mgrms., we can calculate that in order to 
neutralize this quantity of venom and thus save the life of the 
patient 350 c.c. of serum would have to be brought in contact 
with it. In the case of a Daboia bite a much smaller quantity 
of serum would serve the same purpose, as we have seen that 
this snake does not inject so much venom as the Cobra, that the 
serum neutralizes about double the amount of Daboia venom, 
and further that the minimum lethal dose of Daboia venom by 
subcutaneous injection is much greater that than of Cobra 
venom. We can therefore calculate that rI00 c.c. of serum 
would be sufficient to neutralize the amount of venom which 
a full-sized Daboia would be able to inject. 
“We have still to consider the method of injection, as these 
quantities of serum are the amounts which would be required 
to neutralize completely the venoms when they are mixed, in 
vitro, before injection. If, however, the serum be injected 
subcutaneously at the same time as the venom, it was found that 
from ro to 20 times the neutralizing dose of serum was required 
to save the life of the animal. Applying these observations 
to our present purpose, we arrive at the conclusion that in 
treating a case of Cobra bite in which the snake has injected 
the maximum amount of poison, we should have to inject 
350 c.c. of serum intravenously or from 3500 to 7000 c.c. 
subcutaneously in order to save the life of the patient, and in 
the case of Daboia bites 100 c.c. intravenously, or from 1000 to 
2000 c.c, subcutaneously. 
“Further, if symptoms have already appeared before treat- 
ment was begun, larger amounts of serum would be required to 
dissociate the poison from its junction with the cells. If the 
Lille serum be employed, these quantities must be doubled, as 
it is only half the strength of that issued by the Pasteur Institute 
of India. 
“We have no desire to discourage the use of serums, for once 
the poison has been absorbed they are the only remedies available; 
but we wish to point out what is the real neutralizing value of 
the serum, and what may reasonably be expected from its use, 
and, further, to emphasize that quantities of 10 to 30 c.c. as 
recommended by Calmette are hopelessly inadequate, and only 
likely to lead to disappointment.” 
