ANTITOXIC SERA 45 



and cardiac and renal therapeusis, must not be 

 omitted. 



Diphtheria Carriers, — After disappearance of the 

 clinical symptoms of diphtheria it is found that many 

 cases still harbor the bacilli in the nose and throat for 

 variable lengths of time, thus becoming sources where- 

 by the disease is spread to others. Moreover, many 

 persons harbor the organisms who have never had an 

 attack of the disease. Schiotz, of Copenhagen, in 

 1909, after noticing that persons with staphylococcic 

 infections of the nose and throat seldom contracted 

 diphtheria, began to use, with good results, a spray 

 made from a culture of Staphylococcus aureus in per- 

 sons infected with diphtheria bacilli. Reports by 

 many observers show almost uniformly good results 

 from this treatment. Lorenz and Ravenel {Jour, A. 

 M. A,, August 31, 1912, p. 690) recommend a fresh 

 suspension of Staphylococcus pyogenes aureus in nor- 

 mal saline solution or a bouillon culture twelve hours 

 old. This is used as a spray for the fauces, pharynx 

 and nose, after the local signs of diphtheria have dis- 

 appeared, while the cultures for the bacilli are still 

 positive. The spray is repeated at four-hour inter- 

 vals on two succeeding days, and continued there- 

 after until the cultures become negative to diphtheria 

 bacilli. Untoward results are rarely seen. The period 

 of quarantine after diphtheria is greatly shortened by 



