DOSAGE OF TETANUS ANTITOXIN. 419 



the serum into the circulation in order that circu- 

 lating toxin may be neutralized. The intraneural, 

 intraspinal or intracerebral injections should al- 

 ways be supplemented by subcutaneous or intra- 

 vascular injections. The first dose should be given 

 intravenously, whereas subsequent injections may 

 be given subcutaneously. The injections should 

 always be repeated. 



According to Anderson, the prophylactic dose 

 of tetanus antitoxin standardized according to the 

 official standard adopted by the United States 

 Public Health and Marine-Hospital Service is 

 1,500 units. As a curative it should be given in 

 doses of from 3,000 to 20,000 units, repeated dur- 

 ing the course of the disease. 



Agglutination has no practical significance for 

 diagnostic purposes. An agglutinating power has 

 been noted in the serum on the eighth day. Ag- 

 glutinins may be produced by immunizing animals 

 (rabbits) either with the bacilli or the toxin. ID 

 the latter case the formation of the agglutinin i!> 

 due to the presence of agglutinogenic receptors in 

 the toxin solution. 



III. BOTULISM. 



Botulism is a peculiar form of meat poisoning Bacillus 

 in which the nervous system is involved princi- Botlllln ' i s- 

 pally. From twenty-four to thirty-six hours after 

 the poisonous meat is eaten salivation, ptosis, dila- 

 tation of the pupils and paralysis of the ocular 

 muscles develop and death from bulbar paralysis 

 occurs rapidly in from 25 to 30 per cent, of the 

 cases. In the event of recovery, convalescence may 

 extend over weeks or months. 



