TETANUS. % 243 



one gram by weight of rabbit (-f- 1,000,000 K). That 

 serum serves provisionally as tetanus normal antitoxin, 

 Tet AN 1 , whose curative activity Behring and Knorr 

 demonstrated at a meeting of the Physiologic Society in 

 Berlin, on January 13, 1893. This serum, injected on 

 several days successively in doses of 0.04 cu. cm., cured 

 mice that had been infected from twenty -four to twenty- 

 eight hours previously with the lethal minimum dose, and 

 that already presented distinct symptoms of tetanus. One 

 cubic centimeter of this serum contains one normal anti- 

 toxin-unit. For the future it is, however, probable that 

 that serum will be designated as normal antitoxin of which 

 i cu. cm. will render innocuous I cu. cm. of tetanus nor- 

 mal toxin. 



The Hochst Works have placed two preparations on the 

 market. The first occurs in the form of a dry powder 

 packed in 5 -gram vials. This antitoxin has 100 times the 

 strength of the normal (Tet AN 10 ) ; each vial thus con- 

 tains 500 tetanus normal antitoxin-units. The dried serum 

 keeps well, without addition of an antiseptic, in well-closed 

 bottles, and remains of uniform strength. The 500 anti- 

 toxin-units constitute a curative dose for human beings and 

 horses. They are dissolved in 45 cu. cm. of sterile, luke- 

 warm water, not above 40 C. (104 F.), and are injected, 

 in the case of horses, directly into a vein. By introduction 

 into the blood-stream a much more energetic action is 

 obtained, and this, in addition, appears twenty-four hours 

 earlier than after subcutaneous inoculation. For this 

 reason, Behring and Knorr recommend also in human 

 beings, in urgent cases, that the injection be made into a 

 vein. Recovery may be expected after subcutaneous injec- 

 tion in acute cases only when the serum is employed before 

 the lapse of the first thirty -six hours after the symptoms 

 of tetanus have set in. The time lost is less readily com- 

 pensated for by increase of the .dose in the case of tetanus 

 than in that of diphtheria. 



The second preparation dispensed by the Hochst Works 

 is in solution in vials of 5 cu. cm. ; I cu. cm. contains 5 

 normal antitoxin-units the equivalent of five times the 

 normal antitoxin (Tet AN 5 ). As in the case of the diph- 

 theria-antitoxin, 0.5 per cent, of carbolic acid is added to 

 prevent decomposition. This dissolved antitoxin may be 

 employed prophylactically in human beings and animals 



