470 SEROTHERAPY 



may be ascribed to an antitoxic action in infections with the Shiga-Kruse 

 type of bacillus. Infections with the Flexner, Strong, or Y strains, which 

 are relatively poor in toxin production have not been so favorably affected, 

 though some bactericidal action is claimed. The most favorable results 

 are observed in the early stage of the disease. From 20 mils to 100 mils 

 is given subcutaneously. 



ANTIGONOCOCCUS SERUM. A serum prepared by immunizing animal 

 against the gonococcus. 



Serum therapy in gonorrheal arthritis has been reported by some as 

 successful and by others as unsuccessful. The most favorable results 

 have been reported in the joint complications of gonorrhea. Little 

 success has been achieved by the serum treatment of mucous membranes. 



ANTIMENINGOCOCCUS SERUM. A serum prepared by the immunization 

 of horses with virulent cultures of the meningococcus of Weichselbaum. 

 Greater success has attended the use of serum directed against the meningo- 

 coccus than has been the case with any other antibacterial serum. There 

 is no question as to the marked reduction in mortality. The serum must 

 be introduced into the subdural space and its action is due probably in 

 part to bacteriotropins, possibly to anti-endotoxins and other antibodies 

 as well. 



Average dose, 30 mils intraspinally as early as possible in the disease, 

 and repeated as indicated. The serum should be introduced slowly 

 by gravity after the removal of a corresponding amount of the cerebro- 

 spinal fluid. The administration of the serum should be controlled by 

 blood-pressure readings, a drop of 10 mm. mercury during administration 

 being the signal for withdrawal of needle. 



The dried serum is sometimes used as a dusting-powder applied to 

 the nasopharyngeal space or tonsils. 



ANTIPNEUMOCOCCUS SERUM. A serum obtained from horses immu- 

 nized by injection of virulent pneumococci. The value of the serum in 

 pneumonia as usually prepared and administered must remain on the 

 present evidence as "not proved." It is possible, however, that early 

 massive (from 50 to 100 mils) intravenous doses of a highly potent serum, 

 prepared from the exact type of pneumococcus present in the case to be 

 treated, may have a favorable influence on the general symptoms, though 

 probably not on the local process in the lung. Investigations indicate 

 that the pneumococcus in lobar pneumonia may be referred to one of four 

 types in respect to its response to serum treatment. The serum used 

 should be obtained from an animal immunized with pneumoccoci of the 

 type corresponding to that present in the special case under treatment. 



ANTISTAPHYLOCOCCUS SERUM. A serum obtained from horses immu- 

 nized by the injection of staphylococci. Well-controlled evidence of the 

 therapeutic usefulness of antistaphylococcus serum is lacking. 



