48 APPLIED IMMUNOLOGY 



to elapse between receipt of the wound and injection 

 of the serum, the larger the dose of antitoxin required 

 to be efficient. Owing to the fact that the antitoxin is 

 all eliminated from the system in eight or ten days 

 after the injection, and that dormant tetanus spores 

 in the wound may develop after that time, it is ad- 

 visable to repeat the injection during the second week, 

 and if possible again during the third week. In the 

 prophylaxis of tetanus, however, removal of any 

 tetanus bacilH that may be present by thorough open- 

 ing and disinfection of the woimd is of greater im- 

 portance than administration of antitoxin. 



Antitetanic Serum as a Curative Measure, — The 

 efficiency of tetanus antitoxin as a curative agent de- 

 pends on three factors; (1) the site of the injection, 

 (2) thefrequency of the injection, (3) the quantity of 

 antitoxin injected. 



(1) The Site of the Injection, — Of all methods, 

 the subcutaneous inoculation of tetanus antitoxin is 

 least efficient, because, as Ashhurst and John point 

 out, " by this method only a homoeopathic dose ulti- 

 mately reaches the motor nerves through which the 

 toxin is being carried to the spinal cord, while by far 

 the greater part of the antitoxin is distributed to the 

 viscera, where it can be of no possible use. Adminis- 

 tered in this way, overwhelming amounts are required 

 to produce any effect." Clinical and experimental 



