ANTI-DYSENTERIC SERUM. 123 



anti-toxic immunity is not possible experimentally. These differ- 

 ences have been recognized recently and only after much work 

 had been done on the treatment of bacillary dysentery with specific 

 immune sera. Because of this the value of serum therapy in 

 dysentery can be determined only from the relatively recent 

 literature on this subject. 



The results obtained by the use of ant i -dysenteric serum in 

 the treatment of dysentery have differed markedly. In Japan, 

 by the use of Shiga's ant i -dysenteric serum, the mortality of 

 dysentery has been reduced from 22-26 per cent to 9-12 per cent. 

 Vaillard and Dopter have collected statistics on two hundred 

 cases treated with anti -dysenteric serum, in which cases there was 

 a mortality of only 2 per cent. In the United States on the 

 other hand, no great beneficial results have been attained by the 

 use of the serum as is evidenced from the extensive investigations 

 made in 1903 under the direction of Dr. Flexner. 



There are various reasons for the differences in results which 

 have been obtained by the use of anti -dysenteric serum. The 

 patients treated in the United States were largely children under 

 three years of age, while a large percentage of the cases for which 

 favorable results are obtained with serum treatment, occurred 

 in adults. The day of the disease on which serum injections are 

 made is probably earlier in such locations where epidemic dysen- 

 tery is regarded as a serious disease. In the United States many 

 cases of frequency of stool are only simple diarrhoeas, because of 

 this the patient usually receives no medical attention until the 

 disease is well advanced. Probably the most important reason 

 for the difference of the curative value of the different sera is 

 dependent on the differences in the specific substances in the 

 serum. Evidently those sera which have produced the most 

 beneficial results possess anti-toxic properties, while those used 

 in the United States are principally or wholly anti -bacterial. 

 Shiga says of his serum that it is "bactericidal as well as anti- 

 toxic and therefore is more effective than anti-typhoid serum." 

 Practically all of the anti -dysenteric sera have been polyvalent, 

 i. e., the animals furnishing the serum have been immunized to the 

 various strains and toxins of dysentery bacilli, as the case may be. 



The method of treatment with anti-dysenteric serum varies 

 with the severity of the disease. Shiga suggests that in mild 



