STREPTOCOCCUS PYOGENES. 493 



Double the fatal dose of a culture which kills only 

 in a dose of 10 c.c. or over is a more severe test than 

 a thousand times a very virulent one. 



It is entirely different in case of an antitoxin 

 which does not prevent primarily the growth of the 

 germ, but neutralizes a chemical substance its toxin. 



Its Therapeutic Results. To estimate the exact pre- 

 sent and future value of antistreptococcus serum is a 

 matter of the utmost difficulty. Many of the cases 

 reported are of little or no help, because, on account of 

 no cultures having been made, we are in doubt as to the 

 nature of the bacterial infection. Even when bacterio- 

 logical examinations are made during life in cases of 

 septicsemia, they are apt to fail to give us any informa- 

 tion. Under Marmorek's supervision many cases have 

 been injected; thus, even as far back as June, 1895, 

 when his last statistics were published, he had treated 

 96 cases of scarlet fever, 411 cases of erysipelas, 16 

 cases of puerperal fever, and smaller numbers of cases 

 of tonsillitis and of post-operative septicsemia. 



Since then he has treated many forms of phthisis. 

 In all these cases marked improvement is reported to 

 have followed when they were due to streptococci. 

 Thus, in sixteen cases of puerperal fever seven were 

 due to streptococcus alone. All these recovered. 

 Three were due to the streptococcus and colon bacil- 

 lus and one to the colon bacillus alone. These four 

 all died. In five, streptococci were associated with 

 staphylococci. Two of these died, three recovered. 



In phthisis where no cavities have as yet appeared 

 the fever and sweats lessened and all symptoms im- 

 proved. He did not state that any cases were abso- 

 lutely cured. Marmorek's results are by far the best 

 reported, and without casting any doubt upon the in- 



