PRACTICAL APPLICATIONS 3QI 



Allan Macfadyen and others, and is now put on the market by 

 Messrs. Burroughs and Wellcome, under the supervision of 

 Professor Hewlett. Some promising results have already been 

 obtained by its use, and it seems to be quite harmless. It seems 

 only to be of advantage when used in the early stages of the 

 disease, as is naturally the case with any serum which acts by 

 neutralizing a soluble toxin. 



Chantemesse has apparently attained a very high degree of 

 success by the use of a serum obtained by injecting horses with a 

 soluble toxin, prepared by cultivating the bacillus in an extract of 

 spleen digested with pepsin and subsequently neutralized. It is 

 very doubtful that this is the genuine toxin, since it is feeble in 

 action and not destroyed at 100 C. The serum thus obtained is 

 used in very small doses, and appears to act (as pointed out by 

 Wright) rather as a vaccine than as a means of conferring passive 

 immunity. The results, however, appear to have been excellent, 

 but the serum is not yet obtainable commercially. 



Typhoid fever has also been treated by the use of small doses 

 of vaccine, and some promising results obtained ; but the method 

 is still on its trial. 



Preventive Treatment. The earliest method was that of Wright, 

 and it has probably not been surpassed. It consists in the use of 

 vaccines of typhoid bacilli cultivated in broth for twenty-four 

 hours, killed at 60 C., counted by admixture with red corpuscles, 

 and preserved by means of lysol or carbolic acid. Two doses are 

 given, the first being 750 to 1,000 millions, the second twice this 

 amount, the injection being usually made deep in the subcutaneous 

 tissue of the flank. The injections are given at intervals of one 

 or two weeks. Local and general symptoms of some severity 

 follow : redness and swelling at the site of inoculation, lymphan- 

 gitis, etc., with fever, headache, and general malaise. These last 

 but a short time, and no evil consequences have been recorded. 

 It is necessary, however, for the patient to be prepared to stay 

 in bed during the day of inoculation and the next day : the 

 unpleasant effects may be reduced to a minimum by the simul- 

 taneous administration of chloride of calcium by the mouth 

 (15 to 45 grains). 



As a result of these injections, protective substances, and espe- 

 cially agglutinins, make their appearance in the blood, and may 

 persist for several years. These may be taken as affording some 

 test as to the degree of immunity conferred, and as to its duration. 



