SPECIAL SERUM THERAPY. 199 



In this disease favorable results have been observed by the use of 

 Moser's serum. 



Escherich states that of 112 scarlet fever cases injected, those receiving the serum on 

 the first and second days of their illness all recovered while of those injected later on, there 

 was a high percentage of mortality. Other authorities have seen no or only very slight 

 effect from the serum treatment. 



Two hundred cubic centimeters of Moser's serum must be given subcutaneously. 



The treatment of puerperal fever has been favorably influenced by 

 Aronson's and Meyer-Ruppel's serum, of which 50 c.c. are injected on 

 several successive days. 



Menzer's serum is said to serve its purpose best in acute and chronic 

 rheumatism as well as in tuberculous mixed infections. 



In erysipelas all the different well known sera have been employed. On account of 

 the very variable course of the disease it is difficult to judge the exact value of the serum 

 employed. In fact, thus far one cannot with certainty depend upon any serum treatment 

 of a streptococcus infection. The serious nature of such infections, makes every possible 

 therapeutic measure strongly justifiable. 



3. The pneumococcic sera most frequently used are those of Pane, 

 Pneumococ- Romer and Merck. Pane immunizes donkeys with highly virulent pneu- 

 cus Immune mococci and uses the serum for the treatment of pneumonia. Several 

 Sera. Italian investigators record favorable results. 



Romer prepares a polyvalent serum by injecting horses with different strains of 

 pneumococcus obtained directly from man; the strength of the serum is tested in mice. 

 The serum is mainly employed both for the protection and cure of ulcus cornea serpens. 



The result according to Romer depends upon the very variable virulence of the pneu- 

 mococci. The severity of the infection in man is said to run parallel with the virulence in 

 mice. Romer, therefore, ascertains in every case of ulcus serpens whether his serum has 

 any protective bodies for that particular strain of pneumococcus, and tests the virulence 

 of the same. 



The serum can be injected intravenously and subcutaneously, and in pneumococcus 

 meningitis, intradurally. It is manufactured by the Hochst Farbwerke, in vials of 10 

 and 20 c.c. 



A similar serum is manufactured by Merck. It is obtained from horses and stand- 

 ardized at the Institute for experimental therapy in Frankfort o/M. so that o.oi c.c. injected 

 subcutaneously protects a mouse inoculated intraperitoneally twenty-four hours later with 

 10 to 100 times the lethal dose of a living pneumococcus culture. This is known as a 

 normal serum and one cubic centimeter contains one immunity unit (I. E.). The serum 

 on the market contains 20 to 40 units per c.c. 



In pneumonia 200 to 400 units are given subcutaneously and repeated in three to 

 four days, if the fever does not subside. As a prophylactic inoculation 200 to 400 

 units are given to old people where a "hypostatic" pneumonia is feared. In ulcus 

 serpens of the cornea 200 to 400 units are employed and if no improvement sets in, the 

 dose is repeated upon the third day. In addition, several drops of the serum are 

 instilled into the conjunctival sac every two hours. As a prophylactic dose in this 

 disease 100 units suffice. 



Merck also prepares a vaccine of dead pneumococci in doses of i c.c. which further 

 aid in the treatment of pneumococcic infections, i c.c. of such dead pneumococci can 

 be administered for the prophylaxis of ulcus serpens. 



4. Pest Sera. A large number of pest sera are in use. 



