124 VACCINE AND SERUM THERAPY. 



cases one dose of 10 c. c. of the serum be injected. In cases of 

 medium severity two injections of ten c. c. each, the interval be- 

 tween injections ranging from six to ten hours, are recommended. 

 In the severer cases, 40 to 60 c. c. in all are to be injected, but 

 never more than 20 c. c. daily. The serum used in the United 

 States has been injected in larger amounts, sometimes as much 

 as 100 c. c. being injected in one day. 



The effect of treatment with Shiga's serum has been to 

 decrease the number of stools, cause the blood and pus to disap- 

 pear from the stools, restore the temperature to normal, and to 

 lessen the pain and tenesmus. When this serum is used late in 

 the disease the beneficial effects manifest themselves much later. 

 The serum used in the United States has not influenced the course 

 of the disease to any extent, nor is it possible to determine any 

 particular improvement in the condition of patients so treated. 



Coyne and Auche have reported eleven cases of dysentery 

 produced by the Flexrier, or mannite fermenting, type of dysentery 

 bacillus, which were treated very successfully with a polyvalent 

 serum. The curative effects of this serum were probably due to the 

 action of the anti-toxin to the Shiga type of bacillus dysenterine. 



It is to be hoped that specific anti-toxic sera can be made 

 for the mannite fermenting group of dysentery bacilli, or that 

 Shiga type anti-toxin will be found to be efficient in combatting 

 infections with the mannite fermenting group of dysentery bacilli. 

 This is especially desirable because the mannite fermenting 

 organisms are largely responsible for the childrens' summer 

 diarrhoeas in the .United States. 



ANTI-STAPHYLOCOCCIC SERUM. 



Various anti-staphyloccic sera have been made. They are 

 usually obtained from horses and other animals that have received 

 repeated injections of dead and living cultures of these organisms. 

 The method of its action is not clearly understood although any 

 protective value it may have is probably due to lytic and opsoni- 

 fying power. The value of the serum, as it can now be obtained, 

 is inconsiderable, and its injection in the treatment of staphy- 

 lococcus infections is seldom or never warranted. 



