CHOLERA 249 



mended, and it is further advised to repeat the injections after two 

 or three weeks, as the protection only lasts a short time. As the 

 different manufacturers do not employ the same standards the 

 practitioner must use the serum in accordance with the printed 

 directions w r hich accompany the individual package. 



Injections. The injections are given subcutaneously in the usual 

 districts. As the Shiga-Kruse strains alone are toxin producers, 

 while the Flexner type does not belong to this order, and as the 

 serum corresponding to the former is markedly specific in its action, 

 it is advisable to ascertain at the time of an epidemic whether the 

 infection is actually of this type. Unless this is done it would not 

 be warrantable to ascribe a lack of action to the serum when no 

 effect is observed. 



Results. Regarding the results which have been obtained with 

 the serum in question, it seems that the treatment is actually quite 

 useful both for prophylactic and curative purposes, though adequate 

 statistics are not yet available. More convincing than mere figures 

 are the observations which have been made at the sickbed, by 

 individual observers, all of whom speak quite enthusiastically of 

 the marked effect of the injections upon the number of the stools, 

 which frequently drops quite suddenly even within the first twenty- 

 four hours; then upon the pain and upon the general condition of 

 the patient. Even in chronic cases much benefit may be expected. 

 Veillard and Dopter thus mention a case which had lasted five 

 months, in spite of the most varied treatment, where recovery 

 occurred after three injections of serum. 



If we bear in mind that, next to typhoid fever, bacillary dysen- 

 tery is probably the most formidable common disease with which 

 military surgeons have to deal, it would suggest itself that in times 

 of war, or when large bodies of men are concentrated within a 

 narrow compass and are obliged to drink water of unknown quality, 

 prophylactic treatment with antidysentery serum might prove of 

 signal benefit. 



CHOLERA. 



Although a number of different attempts have been made to 

 produce an active antiserum for the treatment of Asiatic cholera, 

 nothing of real value has as yet been accomplished. This is probably 

 owing to the fact that while the symptom-complex of cholera is 



