STREPTOCOCCUS INFECTIONS 255 



25.3 per cent, died, while a delay of from one to four days beyond 

 this period increased the death rate to 27.8 per cent., and a still 

 further delay to 42.1 per cent. The general death rate of 712 treated 

 cases was 31.4 per cent., as contrasted with the usual mortality of 

 from 53 to 90 per cent. By eliminating all those cases where the 

 patients were first seen in an already hopeless condition, but injected 

 nevertheless, Flexner calculated an average mortality of 25.4 per 

 cent. Similar results have been reached with the sera prepared by 

 Wassermann, Jochmann, and Dopter. The latter claims an average 

 mortality of only 16.47 per cent. (402 cases) for his serum, as con- 

 trasted with one of 65 per cent, in untreated cases; Schone one of 

 27 per cent, for Jochmann's serum (in a relatively small number 

 of cases), and Dopter one of 18.35 per cent. (158 cases) for that of 

 Wassermann. 



The immediate effect upon the malady is also quite favorable; 

 usually within twenty-four to forty-eight hours there is definite 

 improvement, as evidenced by a return to consciousness, disap- 

 pearance of delirium, diminution of the general hypersensibility , etc. 

 The duration of the disease is shortened to eight to twelve days, 

 as contrasted with five weeks or longer, which is the rule in fully 

 one-half of the cases that end in recovery, in the absence of serum 

 treatment. 



In conclusion it would seem that late effects of the malady are 

 only exceptionally observed ; mental disorder, paralysis, and blindness 

 in particular are only rarely seen. 



We may accordingly look with pride and satisfaction upon the 

 antimeningitis work as one of the brightest pages in the history 

 of serology. 



STREPTOCOCCUS INFECTIONS. 



Since the days when v. Behring first came forward with the 

 announcement that it is possible with the serum of an animal that 

 has been immunized against the corresponding toxin, not only to 

 protect individuals against diphtheria, but even to cure the disease 

 after this has once developed, attempt after attempt has been made 

 to produce an effective antiserum also against streptococcus infec- 

 tions. But as yet the problem has not been solved. Much work 

 of value has been accomplished, but still more remains to be done. 

 That it is possible to protect animals against a fatal infection with 



