NORMAL HORSE-SERUM 469 



of antitoxin is required but where some of the toxin has combined with 

 the tissue cells a great excess of antitoxin is required to wrest it away. 



NORMAL HORSE-SERUM. The serum of normal horse-blood obtained 

 in a sterile manner and passed through a Berkefeld filter. 



Though not a specific immunity product, normal horse-serum is classed 

 commonly with the other serums. It is claimed to be used with success 

 in hemorrhagic conditions to increase the coagulability of the blood. 



The injection of the horse-serum is followed in certain individuals 

 by more or less pronounced symptoms of anaphylactic shock. In its 

 simplest form this appears as an urticarial eruption on the skin or an 

 edematous swelling of the mucous membranes. In more severe cases 

 there may be a fall of temperature, increased rapidity of pulse, quickened 

 and difficult respiration, cyanosis, and occasionally convulsions. In 

 rare cases the attack comes on with great suddenness and may terminate 

 fatally. These cases of sudden death occur especially in asthmatics 

 and in patients who have been sensitized by close association with horses. 

 Ordinary serum disease manifests itself by milder but similar symptoms 

 which appear from a few days to one or two weeks after the injection 

 of the serum. In addition to the eruptions which are urticarial or scarla- 

 tiniform, joint pains and swelling of the joints sometimes occur. Atropine 

 hypodermatically is a useful remedy for the severer manifestations of 

 serum poisoning. Most cases of this poisoning have occurred after the 

 use of antitoxic serums, but emphasis should be laid on the fact that these 

 symptoms are not caused by antitoxin, but are due to hyper susceptibility 

 to the proteins of horse-serum occasioned by a previous sensitization of 

 the patient by contact with horses or by a previous injection of horse- 

 serum. 



The other antitoxic serums used in curatives serotherapy are exactly 

 the same as previously described under "Prophylactic Antitoxic Sero- 

 therapy." 



2. ANTIBACTERIAL IMMUNITY. ANTI-ANTHRAX SERUM. A serum 

 prepared by immunizing horses against virulent anthrax bacilli. 



Good results have generally been reported from the use of the specific 

 serum in human anthrax. Bactericidal and bacteriotropic properties 

 are practically absent and the virtue of the serum may possibly be ascribed 

 to an inhibition of capsule-formation. 



From 30 mils to 100 mils subcutaneously or intravenously is given. 

 The serum should be used as early as possible and used freely, the dose 

 being repeated several times a day in severe cases. 



ANTIDYSENTERIC SERUM. The blood-serum of horses immunized 

 against the Shiga bacillus and other forms of the dysentery bacillus. 



A reduction in the mortality rate of bacillary dysentery from 30 to 

 50 per cent, through the use of some serums has been reported by some 

 observers but not confirmed by all. It would seem that the best results 



