400 -BA CTERIOL OGY. 



methods. Some speak well of it. No bad results have 

 followed the injections when the serum was sterile and 

 the operation was performed aseptically. 



The Dosage of Tetanus Antitoxin. For immunization 

 10 c.c. of a serum of a strength of 1:1,000,000,000 

 will suffice unless the danger seems great, when the 

 injection is repeated at the end of a week. For treat- 

 ment, it is well to begin with 50 c.c., and then, accord- 

 ing to the severity of the case, give from 20 to 50 c.c. 

 each day until the symptoms abate. In the gravest 

 cases no curative effect will be noticed from the serum. 



Though these few cases are not sufficient to form a 

 final judgment of any treatment, Lambert concludes 

 that by means of the antitoxin treatment, combined 

 with other rational methods, the prognosis, even in 

 acute cases of tetanus, has been improved; but that 

 it still remains exceedingly grave so much so that 

 the preventive inoculation of serum in all cases where 

 dirt has been ground into serious contusions de- 

 serves a much more extensive consideration than has 

 heretofore been given it. The striking results which 

 have been obtained, particularly in veterinary practice, 

 with the prophylactic injection of tetanus antitoxin, 

 would seem to warrant the treating of patients with 

 immunizing doses of serum at least in neighborhoods 

 where tetanus is not uncommon when the lacerated 

 and dirty condition of their wounds may indicate the 

 possibility of a tetanus infection. 



Differential Diagnosis. The differential diagnosis of 

 the bacillus of tetanus is, generally speaking, not diffi- 

 cult, inasmuch as animal inoculation affords a sure test 

 of the specific organism. No other micro-organism 

 known produces similar effects to the tetanus bacillus, 



