6 QUATERCENTENARY STUDIES IN PATHOLOGY 



bodies suitable to the most varying complements, and, at the same time, 

 suitable to being anchored to a great variety of strains of pneumococcus. 

 The practical value of this serum has been favourably extolled by Romer, 

 Axenfeld, and Kriickmann, in the treatment and prophylaxis of ulcus 

 serpens cornecB, but of its use in acute pneumonia the results have not 

 been of such signal success. Thus, Passler {^^\ in 24 cases, had a 

 mortality of 4 (i6*6%) ; he does not advise the general use of the serum, 

 but affirms that, in certain cases of danger, it may be of some service, 

 as the general condition seems to improve after each injection. 



Of the value of Pane's serum the most conflicting results have been 

 published, Fanoni (i^) regards Pane's serum as absolutely specific, and 

 Dasaro-Cao (^2) says that the serum acts promptly as a cure, and the 

 mortality has fallen one-third. Banti and Pieraccini (^3) came to the 

 conclusion that Pane's serum gave no beneficial result in any of their 

 cases, even in large doses. Reports on the value of anti-serum have been 

 given by de Renzi {^^\ Concetti (i^), Righi (^6), Spolverini (^'^\ and other 

 Italians ; by Goldsborough (^s). Sears (^^), Snively (2°), Passler, etc.. etc. 

 The largest number of cases collected from the literature is that of 

 Goldsborough, who published a record of 447 cases with a mortality 

 of i6*5 per cent. Up to the present time (end of 1905) 515 cases have 

 been recorded with a mortality of 15 per cent, which does not show a 

 great deal of improvement on the 17*9 per cent., the average mortality in 

 untreated cases of pneumonia (Fussell). 



Treatment was also tried by use of the serum of pneumonic con- 

 valescents by the Klemperers, Spolverini, Neisser (21), Audeoud (22), etc., 

 but with most indifferent results. 



Mechanism of Immunity. — As to the mechanism by which immunity 

 has been acquired, different opinions have been entertained by the 

 different investigators. Thus the Klemperers, thinking that an antitoxin 

 (antipneumotoxin) was produced in the blood as in diphtheria and 

 tetanus, regarded the action as not directed against the killing of the 

 cocci, but against the neutralisation of the toxin. A substantiation of 

 their opinion they found in the fact that a filtered bacterial-free broth- 

 culture when mixed with immune serum caused no rise in temperature, 

 or only a temporary rise, but alone it killed an animal with the 

 manifestations of high fever. They ascribed the cure of pneumonia in 

 man to an assumed antipneumotoxin production in the blood of the 



(370) 



