824 PASSIVE IMMUNIZATION SERUM THERAPY 



jections of 140 c.c. of serum with 500 to 700 c.c. of sterile salt solution, 

 followed by a similar or slightly lower dosage in from six to twenty-four 

 hours after the first dose. Twelve patients were treated in this way 

 with Kraus' serum with a mortality of 25 per cent., as compared with a 

 general mortality of 75 per cent, in cases receiving no serum. The 

 report of Hundogger 1 upon the use of this serum is unfavorable. A 

 thorough review of the literature and personal investigations of Strong 

 will be found in these papers. 2 The intravenous administration of salt 

 solution alone has proved of value in the treatment of cholera, and it is 

 reasonable to assume that a potent serum may be of service by neutral- 

 izing toxins, destroying the bacilli, and at least furnishing additional 

 fluids for the depleted tissues and circulation. 



There are no available statistics as regards the prophylactic value 

 of anticholera serum, but combined active and passive immunization 

 by means of a subcutaneous injection of from 10 to 20 c.c. of serum, 

 followed by three doses of vaccine, would appear to be a rational pro- 

 cedure in the presence of an epidemic or of a threatened epidemic of 

 cholera. 



THE SERUM TREATMENT OF TUBERCULOSIS 



While numerous efforts have been made to prepare an efficient anti- 

 tuberculosis serum, only two :those of Maragliano and Marmorek 

 have been studied and are familiar. 



Maragliano's serum is prepared by immunizing horses for from four 

 to six months with a mixture of a toxin prepared by the filtration of cul- 

 tures only a few days old and concentrated in vacuo at a temperature of 

 30 C., mixed with that obtained by aqueous extraction of killed virulent 

 cultures and concentrated by heating on a water-bath at 100 C. for 

 three or four days. Maragliano assumes that the antiserum possesses 

 antitoxic, bactericidal, and agglutinating properties. One cubic centi- 

 meter of this serum is injected every other day for one and a half months. 

 The favorable action of the serum is reported on, especially by Mircoli 

 and other Italian physicians, but in Germany and France proof of its 

 value could not be established. 



Marmorek's serum is now prepared by immunization of horses with 

 young tubercle bacilli, whose acid-fast character is still very slight or en- 

 tirely absent. When the horses have attained a high degree of immun- 

 ity, they receive injections of various strains of pure cultures of strep- 



1 Wien. klin. Wchnschr., 1909, No. 52. 



2 Bull. No. 16, Bureau of Govt. Lab., Manila, 1904; ibid., No. 21; Philadelphia 

 Jour. Sci., 1906, i, 501; ibid., 1907, ii, 413. 



