THE SERUM TREATMENT OF STAPHYLOCOCCUS INFECTIONS 819 



Preparation pf Antigonococcus Serum. Torrey's serum is prepared by 

 immunizing rams with gradually increasing intraperitoneal doses of dead, and later 

 of living, cultures of gonococci. Larger amounts of serum may be secured by immu- 

 nizing horses according to the methods described for the preparation of meningococcus 

 and streptococcus immune serums, and in view of the larger doses now advocated, 

 this is advisable. This serum has been successfully concentrated in the same manner 

 as is diphtheria antitoxin. 



Mode of Action of Antigonococcus Serum. According to Torrey, 

 this serum is largely bacteriolytic in nature. The presence of antitoxins 

 has not been demonstrated; small amounts of bacteriotropins are pres- 

 ent, so that a potent serum probably destroys the cocci by extracellular 

 lysis and phagocytosis. 



Administration of Antigonococcus Serum. The amount of serum 

 used and the method of inoculation are very important factors in the 

 success or failure of the treatment. If the serum is used at all, it should 

 be given in large doses. The original method of giving 2 c.c. subcu- 

 taneously has been found inadequate in most instances. 



In acute gonococcal metastases in the joints or in the endocardium 

 or other serous membrane, from 30 to 50 c.c of serum should be injected 

 intravenously, or at least intramuscularly. When gonococci are found 

 in the blood, or when the patient is profoundly septic, from 50 to 100 c.c. 

 of serum should be given intravenously. In epididymitis, orchitis, and 

 other local complications from 30. to 50 c.c. of serum should be given 

 intramuscularly or intravenously. Other forms of treatment should be 

 instituted simultaneously. If necessary, the serum injections should be 

 repeated in twenty-four hours, and if a good primary effect follows an 

 intravenous injection, it may be prolonged by one or more subcutaneous 

 or intramuscular injections on subsequent days 



THE SERUM TREATMENT OF STAPHYLOCOCCUS INFECTIONS 



While several attempts have been made to treat staphylococcus 

 infections with an immune serum, the investigations have been too few 

 and too brief to warrant a statement in regard to the value of serum 

 therapy in these infections. Thomas 1 prepared a serum by immunizing 

 a ram with 18 different strains of Staphylococcus pyogenes aureus, and 

 reported good results in the treatment of 28 cases of furunculosis and 

 carbuncles. 



It is probable that, with more extensive use of antistaphylococcus 

 serum, its value will be proved, especially in the treatment of severe 

 1 Jour. Amer. Med. Assoc., 1913, Ix, 1070. 



