DYSENTERY SERUM 9 1 



The intestinal changes found at post mortem examination of the animals very 

 closely simulate the pathological alterations occurring in man. A hemorrhagic ne- 

 crotic enteritis is present which in rabbits is regularly localized in the appendix and ce- 

 cum, while in dogs the entire intestinal tract and especially the duodenum is attacked, 

 and in monkeys the lower part of the intestine is involved. 



The associated nervous manifestations are, according to experiments of Dopter, 

 referred to changes in the spinal cord itself. These are of a nature similar to acute 

 anterior poliomyelitis. Occasionally a polio-encephalitis is added. 



An antitoxic dysentery serum is obtained by immunization of 

 Dysentery horses and goats. Various methods have been employed 

 Serum. to obtain it. Of the older authors, Shiga and Kruse im- 

 munized animals with dysentery bacteria and thus produced 

 a serum which possessed besides its bacteriolytic and agglutinating 

 properties also a weak antitoxic action. Rosenthal, Todd, Kraus and 

 Doerr employed the toxin itself for immunization purposes. 



In standardization of the serum the properties to be determined are 

 three. [Kraus and Doerr employ rabbits in this work.] 



1. Its power of neutralizing toxin in vitro. Toxin and antitoxin are 

 mixed in various proportions; the mixtures allowed to stand fifteen 

 minutes at room temperature and then injected intravenously. 



2. Its power of neutralizing toxin in vivo. The toxin is injected into 

 the right vein and the antitoxin at the same time into the left vein. 



3. Its curative power. The antitoxin is injected at various intervals 

 after the toxin. 



These three therapeutic factors do not appear simultaneously. The power of 

 neutralization in vitro is first in evidence. Only very much later does the serum de- 

 velop its curative strength and ability to neutralize in vivo. 



In animal experimentation, the antitoxic serum exhibits its neutralizing and cura- 

 tive properties only if injected intravenously. 



Dysentery serum has been employed with fairly good results. Only 

 infections caused by the Shiga-Kruse bacilli can, however, be benefited. 

 The serum should be given subcutaneously and as early in the stage of the 

 disease as possible. The dose advised by the authors varies greatly, 

 on account of the difference in strength of the numerous sera and 

 the severity of the infection. In cases of moderate illness, it is as a 

 rule sufficient to give one to two injections of 20 c.cm. of a strong antitoxic 

 serum which can neutralize toxin both in vivo and in vitro. Vaillard and 

 Dopter have injected as many as 80 to 100 c.cm. in the severer cases. 



The good effect of the serum manifests itself by an improvement in 

 both the general and local symptoms. If high fever exists, the tempera- 

 ture sinks. If collapse temperature is present, it usually rises. The 

 subjective complaints, especially the sleeplessness, improve. The blood 



