ANTITOXINS AND SERUM THERAPY. 63 



a K>ut a fortnight the cultures are extremely toxic. The toxin is 

 obtained free from bacilli by nitration through porcelain. Injec- 

 tions may be given daily, subcutaneously or intravenously, beginning 

 with 1 cc. of iodised toxin, and gradually increasing the dose until 

 the pure toxin may be injected without danger. 



Roux and Yaillard produced immunity in about three months. 

 \Vht-ii a few days have elapsed after the last injection, the blood is 

 drawn, by means of a trocar and cannula, from the jugular vein into 

 a sterilised glass vessel, and set aside to coagulate ; next day the 

 serum is drawn off with a pipette, and used in the liquid state, or 

 dried in a vacuum over sulphuric acid, and subsequently powdered. 

 When required for use the powder is dissolved in cold water. About 

 5 grammes are used for a dose. 



Serum Treatment of Tetanus. The result, so far, of the 

 employment of tetanus antitoxin in animals suffering from tetanus 

 is disappointing, and the serum treatment is not likely to be of much 

 value in veterinary practice. Nocard infected sheep with tetanus 

 by inserting splinters of wood infected with spores into the muscles 

 of the leg. Tetanus supervened in eleven days, and the splinters 

 were removed, the tissues excised, and the wounds dressed with 

 iodoform. About twelve hours after the symptoms had shown 

 themselves, the sheep were inoculated with antitoxic serum at 

 intervals of one hour, but they all succumbed to tetanus. In one 

 case the total amount injected was 160 cc. of highly antitoxic serum. 



The antitoxin has been employed in tetanus in man. Kanthack 

 has collected the history of a number of cases, and they indicate 

 that the treatment is useless in acute cases in man with a short 

 incubation period, while chronic cases with a long incubation period 

 often recover after the treatment. At the same time it must be 

 remembered that recovery often took place in chronic cases before 

 the introduction of the antitoxin treatment. 



The question must still be considered to be sub judice, and a 

 trustworthy conclusion can only be based upon a more extended use 

 of the antitoxin and impartial reports of every individual case. 



ANTITOXIN OF SEPTIC INFECTIONS. 



An anti-streptococcic serum has been prepared by Marmorek. 

 Culture of streptococcus was intensified in virulence by inoculation 

 from rabbit to rabbit, and highly virulent cultures gave rise to a 

 powerful toxin. Roget and Charrin also, found that the serum of 

 immunised rabbits and of a horse conferred immunity. A patient 



