STAPHYLOCOCCUS AND PNEUMOCOCCUS INFECTIONS 243 



who should be consulted in every doubtful case. My belief is that 

 then and only then immunotherapy will yield its best results. 



As I have already indicated, the most favorable reports have 

 been published in connection with the use of the serum in scarlatina. 

 Escherich, speaking of the effect of the Moser serum, remarks that 

 this is "zauberhaft" magic, and especially so when used early. Of 

 1 1 2 cases which had been injected on the second or third day every 

 one recovered, while among those in whom the treatment had been 

 delayed the mortality ranged between 13 and 50 per cent. 



In erysipelas, very curiously, the least favorable results have 

 been obtained; in the migratory forms, however, the disease usually 

 comes to a standstill in from three to four days. The facial cases, 

 of course, should not be included in an analysis of the results, as 

 they usually do well without serum treatment. In puerperal cases 

 the testimony is most conflicting. Some observers, such as Bumm, 

 Peham, and Burkard, thus speak quite favorably of its use (when 

 employed early), Burkard reporting 50 cases, of which twenty-nine 

 were pure streptococcus infections, without a single death, while 

 others deny having seen any good accomplished whatever. It is 

 in these very cases where I would advocate that the serum treat- 

 ment should be placed in the hands of experts who shall decide how 

 the serum is to be given, when it is to be given, and how much is to 

 be given. That even then there will be unfavorable results also is 

 to be expected, but it would stand to reason that the maximum 

 amount of good that could be accomplished would be obtained under 

 such conditions. 



Regarding the value of the serum in other streptococcus infections, 

 too little is as yet known to warrant any definite conclusions. Here 

 also is a large field for the expert, and until it is tilled by him the 

 results can hardly be expected to be what they should be. As I have 

 suggested, the best results may here be expected from serum treat- 

 ment and vaccine treatment conjointly. 



STAPHYLOCOCCUS AND PNEUMOCOCCUS INFECTIONS 



While several attempts have been made to combat staphylococcus 

 and pneumococcus infections with corresponding antisera, we know 

 too little as yet of their mode of action and their effect as to warrant 



