EMPLOYMENT OF BLOOD SERUM 263 



days, while the average duration of eighty-seven control cases was 18.6 

 days. A few cases proved to be persistent carriers. The less favorable 

 results obtained by Kretschmer, Blumenau and Nolf may be explained 

 by their small series of treated cases, weak sera and ineffective methods 

 of application of the serum. Although the results so far obtained are 

 not entirely convincing, the use of anti-bacterial serum in the treatment 

 of diphtheria still deserves careful consideration. It is not pos- 

 sible to resort to tonsillectomy or adenoidectomy in all instances, 

 and the majority of antiseptics are irritant. In many instances it is 

 practically impossible to reach the organisms because they are buried 

 in crypts, and tonsillectomy remains as the favored mode of treatment, 

 although even this method is not invariably successful. 



Anti-gonococcus Sera. The early work of Rogers and Torrey 

 has led to attempts at treatment of gonococcal infections by means of 

 immune sera. Torrey's serum is prepared by injecting sheep with 

 dead and subsequently living cultures of virulent strains of the gono- 

 coccus. Although efforts have been made to treat urethral, vulvar 

 and vaginal gonorrhea by local applications of serum the disposition 

 of the organisms in deep glands has been sufficient to result in the 

 failure of this method. Recent studies of Debre and Paraf offer some 

 encouragement for the treatment of gonorrheal rheumatism by the use 

 of polyvalent sera, but they find that local injections about the site 

 of the disease are more effective than general subcutaneous or intra- 

 venous injections. Further studies may demonstrate the value of 

 serum treatment of chronic gonorrheal infections, but at the present 

 time the method cannot be highly recommended. 



Serum Treatment of Tuberculosis. The best-known sera for use 

 in tuberculosis are those of Maragliano and Marmorek. The first is 

 prepared by immunizing horses with a mixture of a toxic filtrate of 

 the bacilli and an aqueous extract of killed virulent tubercle bacilli. 

 One cubic centimetre of the immune horse serum is injected into the 

 patient every other day for a period of one and one-half months. A 

 number of Italian workers found the serum effective, but other ob- 

 servers have not been convinced of its value. Marmorek's serum is 

 prepared by inoculating horses with young tubercle bacilli poor in acid 

 fast character. In addition, Marmorek immunized animals with pure 

 cultures of streptococci obtained from the sputum of tuberculous 

 patients. This serum is injected subcutaneously in daily doses of from 

 5 to 10 c.c. or intrarectally in doses of from 10 to 20 c.c. A number of 

 workers, as for instance Wohlberg, have reported a favorable influence ; 

 others deny this effect. Wohlberg found the best results in scrofulous 

 cases but not in cases of fully developed tuberculosis. The benefits of 

 serum therapy of tuberculosis have not been convincing. 



Serum Treatment of Typhoid Fever. Lewin and Yes, Beumer 

 and Pfeiffer and Chantemesse were among the first to produce antisera 

 for this disease. Chantemesse's antiserum was prepared by immuniz- 

 ing horses with soluble toxins of the typhoid bacillus. Balthasard 

 tested this serum and found it to agglutinate typhoid bacilli in very 



