516 PATHOGENIC BACTERIA. 



in moderate quantities after twenty-four hours. Milk is 

 not coagulated. 



The blood-serum of those suffering from the dysentery 

 or recovered from it causes a well-marked agglutinative 

 reaction. This agglutination has been further studied 

 by Flexner, and is thought to be specific and useful for 

 diagnosis. 



By the progressive immunization of horses to an im- 

 munizing fluid, the basis of which is a twenty-four hour 

 old agar-agar culture dried in vacuo, Shiga has prepared, 

 an antitoxic serum, with which, in 1898, 65 cases were 

 treated, with a death-rate of 9 per cent. ; in 1899, 91 

 cases, with a death-rate of 8 per cent. ; in 1899, no cases, 

 with a death-rate of 12 per cent. These results are very 

 significant, as the death-rate in 2736 cases simultaneously 

 treated without the serum averaged 34.7 per cent., and 

 in consideration of the frequency and high death-rate 

 of the disease, Japan alone, between the years 1878 and 

 1899, furnishing a total of 1,136,096 cases, with 275,308 

 deaths (a total mortality for the entire period of 24. 23 per 

 cent.). 1 



The epidemic dysentery is apparently a different disease 

 from the amebic form, the chief points of dissimilarity 

 being that the extensive undermined ulcerations, de- 

 scribed by Councilman and Lafleur, are rarely observed. 

 The follicular, pustule-like ulcer is very uncommon; per- 

 foration is unusual, the muscular coat offering strong re- 

 sistance to the disease-process. Abscess of the liver is 

 also rare in epidemic, though common in amebic, dysen- 

 tery. 



It is not improbable that the bacillus of Shiga is 

 identical with the Bacterium colt, variety dysenteries, of 

 Celli, Fioca, and Scala. 1 



1 Public Health Reports, Jan. 5, 1900, vol. xv., No. I. 



1 Hygien. Institut. Rom. Univ., 1895, anc * Centralbl. f. Bake. 11. Parasitenk. y 

 1899. 



