THE SERUM TREATMENT OF MENINGOCOCCUS MENINGITIS 789 



After pursuing experimental studies on the subject on the lower 

 animals, Jochmann, 1 in 1905, immunized a horse and used the serum in 

 the treatment of 38 cases of epidemic meningitis. At first he employed 

 the subcutaneous method of injection, and later he used the intraspinal 

 method. The results were quite encouraging, and during the following 

 year 30 more cases were treated, with a resulting mortality of 27 per 

 cent., as against a mortality of 53 per cent, in untreated cases. 



At about the same time Kolle and Wassermann 2 reported that they 

 had prepared an antimeningococcus serum, which had not, however, 

 up to that time been used in the treatment of human infections. A year 

 later serum was administered subcutaneously and then intraspinally, 

 with encouraging results. 



In this country Park had, in 1905, prepared an antimeningococcus 

 serum, which was used in the treatment of 20 cases in Hartford, Conn., 

 by subcutaneous injection, but without beneficial results. Jochmann 

 had, in the mean time, shown the superiority of intraspinal injections, 

 and this method soon supplanted the subcutaneous method. 



In 1905 Flexner began a series of studies regarding experimental 

 meningococcus infections in the lower animals, and the therapeutic 

 value of antimeningococcus serum. These valuable experiments at- 

 tracted the attention of the world, and placed this method of treatment 

 upon a firm basis. In 1906 Flexner 3 proved that a specific immune 

 antimeningococcus serum could be produced that, if injected intra- 

 spinally, would save the lives of monkeys. Later horses were immunized 

 and the serum used in the treatment of human infections during an 

 epidemic in Akron, Ohio, in May, 1907. In a short time the serum was 

 used extensively in other epidemics, and a report of these early cases was 

 made by Flexner 4 in 1907. A later report by Flexner and Jobling, 5 

 covering the treatment of 400 cases, showed that the mortality had been 

 reduced from 75 per cent, to below 30 per cent. In 1909 they reported 6 

 upon 712 cases treated with the serum, with a mortality of 31.4 per cent. 

 In a more recent report Flexner 7 reviewed all the cases 1300 in number 

 gathered from all parts of the world, treated with serum prepared in 

 the Rockefeller Institute. The general mortality rate is given as 30.9 

 per cent., as against 75 to 80 per cent, among cases not receiving serum 



1 Deut. med. Wochenschr., 1906, xxii, No. 20, 788. 



2 Deut. med. Wochenschr., 1906, xxxii, No. 16. 



3 Jour. Amer. Med. Assoc., 1906, xlvii, 560. 



4 Jcur. Exper. Med., 1907, ix, 168. B Jour. Exper. Med., 1908, x, 141. 



6 Jour. Amer. Med. Assoc., 1909, liii, 1443. 



7 Jour. Exper. Med., 1913, xvii, 553. 



