1S89— 1895 



It was sufficient to examine a portion of diphtheritic 

 membrane to distinguish the diphtheritic bacilli, tiny rods 

 resembling short needles laid across each other. Other 

 microbes were frequently associated with these bacilli, and it 

 became necessary to study microbian associations in diphtheria. 

 The Klebs-Loeffler bacillus, disseminated in broth, gave 

 within a month or three weeks a richly toxic culture ; the 

 bottom of the vessel was covered with a thick deposit of 

 microbes, and a film of younger bacilli floated on the surface. 

 By filtering this broth and freeing it from microbes, Messrs. 

 Koux and Yersin made a great discovery : they obtained pure 

 toxin, capable of killing, in forty-eight hours, a guinea-pig 

 inoculated with one-tenth of a cubic centimetre of it. 



Now that the toxin was found, the remedy, the antitoxin, 

 could be discovered. This was done by Behring, a German 

 scientist, and by Kitasato, a Japanese physician. Drs. Bichet 

 and Hericourt had already opened the way in 1888, while 

 studying another disease. 



M. Koux inoculated a horse with diphtheritic toxin miti- 

 gated by the addition of iodine, in doses, very weak at first, 

 but gradually stronger ; the horse grew by degrees capable of 

 resisting strong doses of pure toxin. It was then bled by 

 means of a large trocar introduced into the jugular vein, the 

 blood received in a bowl was allowed to coagulate, and the 

 liquid part of it, the serum, was then collected; this serum 

 was antitoxic, antidiphtheritic — in one word, the long-desired 

 cure. 



At the beginning of 1894, M. Boux had several horses 

 rendered immune by the above process. He desired to prove 

 the efficiency of the serum in the treatment of diphtheria, with 

 the collaboration of MM. Martin and Chaillou, who had, both 

 clinically and bacteriologically, studied more than 400 cases of 

 diphtheria. 



There are in Baris two hospitals where diphtheritic children 

 are taken in. It was decided that the new treatment should 

 be applied at the hospital of the Enfants Malades, whilst the 

 old system should be continued at the Hopital Trousseau. 



From February 1, MM. Koux, Martin, and Chaillou paid a 

 daily visit to the Enfants Malades ; they treated all the little 

 diphtheria patients by injection, in the side, of a dose of twenty 

 cubic centimetres of serum, followed, twenty-four hours later, 

 by another dose of twenty, or only of ten cubic centimetres. 



