820 PASSIVE IMMUNIZATION SERUM THERAPY 



furunculosis of infants as well as of adults, when the low general vitality 

 of the patient contraindicates the use of a bacterial vaccine. With 

 extended use it may also be found to be of benefit in staphylococcus 

 bacteremia, osteomyelitis, arthritis, carbuncle, and other severe in- 

 fections. Following recovery or relief from an acute infection it would 

 seem to be wise actively to immunize the patient with a vaccine, or 

 serum and vaccine may be used conjointly. 



The activity of the serum is probably largely dependent upon the 

 presence of bacteriotropins and antitoxins, the former promoting phag- 

 ocytosis and the latter neutralizing the staphylolysins or hemotoxic 

 poisons produced by staphylococci. 



THE SERUM TREATMENT OF ANTHRAX 



Sclavo, 1 Mendez, 2 and Deutsch 3 have prepared anti-anthrax serums 

 by immunizing sheep, goats, asses, and horses with virulent cultures of 

 anthrax bacilli. In the treatment of human infections, only Sclavo's 

 serum has been used, the others being used in the treatment of anthrax 

 among the lower animals. An anthrax serum prepared by American 

 manufacturers is also on the market. 



Sclavo's serum has been shown to possess protective and therapeutic 

 properties in experimental infections, and favorable results have been 

 recorded in cases of human anthrax. According to Sclavo's statistics, 

 the serum has reduced the average mortality of anthrax from 24 per 

 cent, to 5.3 per cent. Cigognani, Legge, Lockwood and Andrewes, 

 Stretton and Mitchell, and others have reported favorably as to the 

 value of the serum. 



It is somewhat difficult to prepare a potent serum, and horses should 

 be immunized with a large number of strains from human infections over 

 a long period of time. The serum is probably largely bacteriotropic and 

 bacteriolytic in nature. 



Administration of Anti-anthrax Serum. In the Philadelphia Hos- 

 pital for Contagious Diseases a number of anthrax cases are treated 

 every year. Whenever blood-cultures have revealed the presence of the 

 bacilli in the circulation, the patient has usually succumbed to the disease 

 in spite of serum treatment; the doses employed 10 to 20 c.c. may, 

 however, have been too small. I would recommend the following 

 course of treatment in these cases : 



1 Berl. klin. Wochenschr., 1901, 18 and 19, 481, 520. 



2 Centralbl. f . Bakt., 1899, xxvi, Nos. 21 and 22. 



3 Impfstoffe u. Sera, Leipzig, 1903. 



