84 TOXIN AND ANTITOXIN. 



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 ante- 

 rior 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. in its obtention. Of the older authors, Shiga and Kruse 

 immunized animals with dysentery bacteria and thus produced 

 a serum which possessed besides its bacteriolytic and agglutinating proper- 

 ties 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 neutral- 

 ization in vitro is first in evidence. Only very much later does the serum develop its 

 curative strength and ability to neutralize in vivo. 



In animal experimentation, the antitoxic serum exhibits its neutralizing and curative 

 properties only in cases where intravenous injections are applied. 



Dysentery serum has been employed with fairly good results. Infections 

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

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

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

 account of the inconstancy 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.c. of a strong antitoxic serum which can neutral- 

 ize toxin both in vivo and in vitro. Vaillard and Dopter have injected as 

 many as 80 to 100 c.c. 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 temperature sinks. 

 If collapse temperature is present, it usually rises. The subjective com- 

 plaints, especially the sleeplessness, improve. The blood in the stools dis- 

 appears; the movements of the bowels become less frequent and the severe 

 pains concomitant with the same are absent. Finally, the consistency of 

 the stools changes and at the end becomes normal. 



Prophylactic use of the serum has met very favorable confirmation in the 



