168 SUPPURATION PUS COCCI. 



on all streptococcus infections. The serum is prepared by 

 immunizing an animal to live cultures of a very virulent 

 streptococcus. The streptococcus toxin is a diastase which 

 is destroyed when it is exposed to a temperature of 70 C. 

 Although all the streptococci are believed to be of one 

 common species, the antistreptococcus serum apparently pos- 

 sesses bactericidal properties only for the streptococcus from 

 which it is prepared. Many observers are of the opinion, 

 however, that the serum of any one streptococcus antagonizes 

 all streptococci more or less. The serum should always be 

 kept in a cool dark place, as it deteriorates very rapidly. 



Marmorek's observations have been confirmed by many 

 reliable investigators. The serum has been used in scarlet 

 fever, erysipelas, puerperal fever, tonsillitis, post-operative 

 septicaemia, phthisis, and bronchopneumonia, with very grati- 

 fying results. It should be used only in suitable cases, and 

 the serum must be fresh. A serum which is more than six 

 weeks old should not be used, as it is practically inert after 

 that time. 



The daily dose varies with the severity of the condition. 

 Ordinarily from 20 to, 50 c.c. of the standardized serum can 

 be used daily without exhibiting ill effects. 



Some very excellent results have been obtained with Mar- 

 morek's serum in streptococcus pneumonias. It is practically 

 devoid of effect in the pure pneumococcus pneumonia or in 

 the pneumonia complicating la grippe or typhoid. In the 

 stage of mixed infection in phthisis, the ulcerative stage, this 

 serum can be used with benefit. 



It may be of interest to refer briefly at this time to Coley's 

 serum. It was noticed by a number of clinicians that an 

 accidental infection of malignant tumor? with Streptococcus 

 erysipelatis was in some instances followed by a complete dis- 

 appearance of the tumor. Coley verified these findings 

 experimentally. He found further that the toxin of the 

 streptococcus was preferable to the living culture. Also, that 

 when mixed with Bacillus prodigiosus the efficiency of the 

 serum is increased considerably. 



Flasks containing slightly acid bouillon are inoculated with 

 a virulent culture of the streptococcus obtained from the ery- 



