STAPHYLOCOCCUS INFECTIONS 263 



to inject a small quantity (about 0.5 c.c.) a few hours before the 

 principal injection is given, the idea being to guard against anaphy- 

 lactic reactions by the production of the antianaphylactic state. 

 Following the second injection no anaphylactic disturbances need 

 of course be anticipated (for the same reason). Above all it is 

 essential to inject as soon as the diagnosis has been made. 



Results. Regarding the results which may be obtained with 

 antipneumococcic sera prepared along the lines which have been 

 indicated by Neufeld and Handel, it would be premature to make 

 any definite statements. Suffice it to say that the treatment has 

 no appreciable influence upon the pathologico-anatomical condition 

 of the lung, but that the general condition of the patient is appar- 

 ently improved and that an early crisis may be expected if the serum 

 is administered early. To what extent the death rate will be affected 

 by the treatment is impossible to foretell from the meager data which 

 are now available. Of the thirty-seven cases treated by Betz and 

 Geronne, five died, but of these several were tubercular, and one in 

 an extremely critical condition, when injected (on the sixth day). 



In localized infections with the pneumococcus it would seem 

 advisable to combine the serum treatment with the use of sodium 

 oleate and boracic acid, as recommended by Lamar (see section on 

 Chemotherapy). 



STAPHYLOCOCCUS INFECTIONS. 



While several attempts have been made to combat staphylococcus 

 infections with corresponding antisera, we know too little as yet 

 of their mode of action and their effect as to warrant more than a 

 mere statement of this fact. Noteworthy clinical results have 

 apparently not as yet been achieved. The great question here, as 

 elsewhere in the treatment of bacterial infections with antisera, is 

 whether or not all the organisms are of one type. If this should not 

 be the case it is clear that only a homologous serum would likely be 

 of value, and as a matter of fact, evidence is rapidly accumulating 

 which goes to show that marked differences actually exist between 

 staphylococci derived from different sources. 



