gS BACTERIOLOGY 



to combine with and render inert. Until the toxins 

 are set free from the germ the antibodies are unable to 

 combine with them, hence the phagocytic destruction 

 of the germs is necessary to the success of the treatment. 



Method of Administration, Dosage, etc. Because the 

 phagocytic action of the serum occurs only in concen- 

 trated solutions and because this must precede its an- 

 titoxic action, the serum is injected directly into the 

 spinal canal where it can come into direct contact with 

 the germs with a minimum of dilution. 



The dose is from 20 to 45 c.c. in adults and 10 to 30 

 c.c. in children. A similar amount of cerebrospinal 

 fluid is withdrawn by lumbar puncture and the serum 

 introduced in its stead. 



The dose should be repeated for three or four consec- 

 utive days unless the improvement is so great as to 

 warrant the discontinuance of the treatment. The best 

 guide is the condition of the spinal fluid, which should 

 be examined at frequent intervals. As long as it shows 

 the presence of meningococci the injections should be 

 continued. 



Results of Treatment. When the serum is used 

 early and in sufficient doses the results are extremely 

 gratifying. Coma, headache, delirium, and insomnia 

 disappear at once. The temperature falls perhaps to 

 normal. The paralysis improves or entirely disappears. 

 In fact, the cases which recover are entirely free from 

 the hideous deformities and defects, such as deafness, 



