264 THE PRINCIPLES OF IMMUNOLOGY 



high dilutions and to protect animals under experimental conditions. 

 In 1000 cases of typhoid fever, Chantemesse reduced the mortality to 

 4.3 per cent, whereas the mortality among 5621 cases at the other 

 hospitals in Paris not treated with serum was 17 per cent. Similar 

 favorable reports were made by Brunon and Josias. Kraus and 

 Stenitzer also produced antitoxic sera by immunizing their animals 

 with soluble toxins and Cjaupp claims that the serum can be used with 

 advantage in the treatment of the disease. Besredka and Liidke pre- 

 pared sera by immunizing horses and goats with the endotoxin of the 

 typhoid bacillus, but it seems that the serum is not primarily an anti- 

 endotoxin but rather a bactericidal serum which neutralizes both the 

 exo- and endotoxins of the typhoid bacillus. According to Andriesen 

 and Cinca, it can be used clinically. Sera were also prepared by im- 

 munizing animals with sensitized cultures of the typhoid bacillus and 

 also with products obtained by digesting typhoid bacilli with trypsin. 

 This toxic compound is known as "Fermotoxin" (Gottstein and 

 Mathes). Rommel and Herman failed to obtain encouraging results 

 with serum prepared by immunization with sensitized bacilli. The most 

 favorable results, however, were secured by Rodet and Langrifoul. 

 These authors immunized horses intravenously with both living cultures 

 and old endotoxins, and in a summary of 400 cases Rodet finds that by 

 repeated injections of this serum in doses from 10 to 20 c.c. given sub- 

 cutaneously every other day the duration of the fever is markedly 

 reduced in cases that are treated early. Serum treatment appears to 

 reduce the bacteremia. It is also known that twenty-four hours after 

 the injection of serum a definite increase in splenic dullness is observed, 

 which presumably indicates a general stimulation of the lymphoid and 

 myeloid tissue. The self -limitation of the disease, in the absence of 

 complications, throws some doubt on the practical value of such sera. 



AUTO-SERUM THERAPY 



The use of the patient's own serum in the treatment of his disease 

 has been suggested and applied by a number of workers. Gilbert, 

 Marcon and many others treated tuberculous peritonitis and tubercu- 

 lous pleurisy with effusion, by the subcutaneous injection of i. c.c. to 

 2. c.c. of the patient's own serum and claim that the absorption of the 

 exudate is greatly increased and an immediate improvement occurs. 

 Eisner observed a leucocytosis following the injection of the serum 

 in experimental tuberculous infections of rabbits and guinea-pigs and 

 believes that this fact explains the favorable results reported in this 

 method of treatment. Other investigators believe that specific antibodies 

 favorably influence the process, but Levy, Valenzi and others are 

 inclined to believe that the results are independent of the injections. 

 It is possible that simultaneously with the transfer of the serum a 

 minute amount of tuberculin is introduced. The exact nature of the 

 phenomenon is, however, obscure. In influenza, Malta fever and 

 typhoid fever Modinos has also obtained beneficial effects and Jez 

 applied the treatment favorably in erysipelas. Capogrossi more re- 



