SERUM THERAPY 95 



more toxin there is in the body that must be neutralized 

 before recovery can occur. 



Administration. The loose skin of the buttocks, 

 between the shoulders, or of the anterior abdominal 

 wall is usually selected as the site of injection. The 

 skin should be thoroughly scrubbed with soap and water, 

 followed by alcohol or, what is more efficient, simply 

 painted at the point of injection with tincture of iodin. 

 The syringe container is removed from its package 

 with sterile hands and its contents injected into the sub- 

 cutaneous cellular tissue. A drop of collodion may be 

 applied to the needle wound. 



Effects. If the dose has been sufficient within a 

 short time, varying with the severity of the disease and 

 the period of administration, improvement in all the 

 symptoms will be manifest. The temperature will fall, 

 the pulse improve, the membrane cease to advance 

 and begin to loosen up at the borders, being finally 

 coughed up piecemeal or en masse. Should such im- 

 provement not occur within five or six hours, it is 

 evidence sufficient that the dose has not been large 

 enough, and that another and larger dose should be 

 injected. 



Tetanus antitoxin is prepared from the horse in prac- 

 tically the same manner as the diphtheria antitoxin. 

 Tetanus toxin is injected in increasing doses until the 

 horse ceases to react, when he is bled and the serum 

 separated, as in the manufacture of the diphtheria serum. 



