THE SERUM TREATMENT OF PLAGUE 769 



According to Chantemesse, the subcutaneous injection of a few drops 

 of his serum produces leukocytosis and raises the opsonic index of the 

 patient's serum. He emphasizes the fact that the serum should be given 

 early, before the seventh day, and reports that, by its use, the mor- 

 tality has been reduced from 17 per cent, to 4.3 per cent. These results 

 have not been generally confirmed, and the subject is still sub judice. 



THE SERUM TREATMENT OF PLAGUE 



Of the various antipest serums that have been prepared, that of 

 Yersin is probably best known. This serum, it would appear, possesses 

 some prophylactic and therapeutic value. For purposes of prophylaxis 

 from 10 to 20 c.c. of serum may be injected subcutaneously or intra- 

 venously; the period of protection is short, averaging from ten to four- 

 teen days. Combined active and passive immunization, effected by means 

 of injections of a pest vaccine and an antipest serum, will probably exert a 

 protective action of several months' duration, and should be used by physi- 

 cians, nurses, and others during epidemics of plague. When used for 

 therapeutic purposes, the results have been quite variable. If serum is 

 used in the treatment of plague, it should be given as early as possible, 

 in the form of intravenous or intramuscular injections of from 50 to 150 

 c.c., if this amount is available. Injections should be continued at 

 twelve- to twenty-four-hour intervals for two or more days until sup- 

 puration has been controlled and the disease shows signs of abating. 

 The Plague Oommission of India has not issued very favorable reports 

 upon the use of either this serum or that of Lustig. 



(a) In addition to Yersin's serum, which is prepared at the Pasteur Institute of 

 Paris by immunizing horses with dead and then with living cultures of pest bacilli, 

 other serums have been prepared. For example: 



(6) Kolle immunizes horses with intravenous injections of heat-killed cultures, 

 beginning with Y agar slant culture and doubling the dose each week until 15 cul- 

 tures are given at one time. The horses are bled fourteen days after the last dose 

 is given. 



(c) Lustig immunizes horses with pest-nucleoproteins, obtained by breaking 

 up the bacilli with 1 per cent, of potassium hydroxid and precipitating the proteins 

 with acetic acid. These are then suspended in sterile normal salt solution, as in the 

 preparation of Lustig's vaccine. 



(d) Terni-Bandi immunizes donkeys and sheep with aggressins obtained by 

 intraperitoneal injection of guinea-pigs with pest bacilli. 



(e) Markl immunizes horses with filtrates of old pest bouillon cultures. He 

 believes that the value of pest serum is largely dependent upon antitoxins. 



The serums are usually tested by injecting mice with lethal doses of pest culture 

 and decreasing doses of antiserum. The agglutinin content may also be measured. 

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