244 CLINICAL BACTERIOLOGY. 



after such injuries as experience has shown may be followed 

 by tetanus. The size of the dose (from 0.5 to 5 cu. cm.) 

 is governed by the period of time that has elapsed since 

 the infliction of the injury. If it be desired to make an 

 injection of antitoxin in advance of an operation that is 

 frequently followed by tetanus in animals as, for instance, 

 preceding castration 0.2 cu. cm. will suffice. - 



Recent observations have afforded noteworthy support 

 for the justification and the utility of serum-therapy with 

 relation to tetanus. Donitz established the fact in the 

 Institute for Serum-therapy that the tetanus-toxin, as soon 

 as it enters the blood, is taken up by the tissues of the body, 

 and that, in cases of severe intoxication, the simple lethal 

 dose is bound within from four to eight minutes. The 

 serum, however, separates the toxin from its combination 

 with the tissues, and neutralizes it. The dissolution of the 

 toxin-combination is effected 'with the greater difficulty the 

 severer the intoxication and the longer the period of time 

 that has elapsed before the serum is employed. Of especial 

 significance is the discovery by Goldscheider and Flatau 

 that certain degenerative processes affecting nerve-cells that 

 are caused by tetanus-intoxication recede under the influence 

 of the serum. We have thus anatomic evidence for the 

 curative activity of the serum.* 



As to the results of tetanus-therapy, a definite opinion 

 can not yet be given, as the new preparations have been 

 generally available for too short a time. As bearing upon the 

 value of prophylactic inoculations in veterinary medicine, we 

 have the statistics of Nocard, covering the period from 

 August I, 1895, to June I, 1897. Altogether, 2707 animals 

 were vaccinated. Of this number, 2300 received an injec- 

 tion of serum immediately after the operation (castration, 

 amputation of the tail, etc.). Not one of these animals 

 developed tetanus. The remainder were inoculated from 

 one to four days after the operation or after the infliction 

 of a traumatism. Only one horse exhibited symptoms of 

 tetanus, but these rapidly subsided. Nocard considers these 

 results as quite remarkable, as the animals were derived 

 from stables in which tetanus had prevailed shortly before. 

 On the other hand, the sixty -three veterinary surgeons who 



* The results appear, further, to be more promising when the serum is in- 

 troduced beneath the dura mater than after any other method of introduction. 

 A. A. E. 



