DYSENTERY 231 



100 c.c. on the first day, and have repeated this on the following 

 days. In three instances 240, 380 and 1080 c.c. were injected, 

 altogether, i. e., doses which seem unwarrantably and unnecessarily 

 large, if an active serum was really at hand. After the disease 

 comes under control, as is evidenced by a diminution in the number 

 of the stools, smaller doses may be given during the following days. 



For prophylactic purposes the same dosage (10 to 20 c.c.) is 

 recommended, 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 which 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 dysentery 

 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. 



