THERAPEUTIC IMMUNIZATION IN MAN 477 



active minimum seem to exert absolutely no beneficial action. This 

 is a fact which later was also determined by Dochez. 



In confirmation of the work of Neufeld and Handel 58 Dochez 

 and Gillespie 59 have also been able to determine that there are at 

 least two distinctive groups of pneumococci which differ from each 

 other as far as agglutination and serum protection experiments are 

 concerned. In addition to these two fixed types they separate as a 

 third group the streptococcus or Pneumococcus mucosus and a fourth 

 heterogeneous group which seems to fit in with none of the others as 

 far as serum reactions can determine. 



Cole, 60 therefore, adopts the reasoning of ISTeufeld in that he 

 advises the determination of the type of pneumococcus present in 

 cases of pneumonia as a guide to the type of antiserum to be used. 

 The type of organism is determined as soon as a case comes under 

 observation and 50 to 100 c. c. of the homologous antiserum is in- 

 jected intravenously. The result in the few cases so far treated by 

 Cole and his associates has been encouraging. 



Protective substances, according to Dochez, appear in the serum 

 of treated cases very shortly after the administration of the serum, 

 whereas in untreated lobar pneumonia such protective substances 

 usually do not appear until after the crisis. Apparently Cole believes 

 that the great value of passive immunization of this kind in pneu- 

 monia lies in the fact that the bacteriemia shown to prevail in prob- 

 ably all cases of lobar pneumonia is either cured or improved by the 

 treatment, converting the disease, which is by nature, at least for a 

 time, a septicemia, into a localized pulmonary infection. Experi- 

 ence with antipneumococcus serum so far has been too limited to 

 warrant final judgment as to its permanent place among therapeutic 

 agencies. 



THE SERUM TREATMENT OF TYPHOID FEVER 



The first extensive attempts to treat typhoid fever by passive im- 

 munization with the serum of treated animals were made by Chante- 

 messe, who immunized horses with filtrates of typhoid cultures sub- 

 cutaneously, and with emulsions of virulent bacilli intravenously. 

 Chantemesse believed that the serum of horses which had been 

 treated in this way for very long periods possessed, not only bacteri- 

 cidal action, but stimulated phagocytosis, and possessed a certain 

 limited amount of neutralizing power against the toxic properties of 

 the typhoid filtrates. At the International Congress of Hygiene in 

 Berlin in 1907 Chantemesse 61 reported upon a thousand cases 



58 Neufeld and Handel. Arb. aus dem kais. Gesundh. Ami., Vol. 34, 1910. 



59 Dochez and Gillespie. Jour. A. M. A., Vol. 61, p. 727, 1913. 



60 Cole. Jour. A. M. A., Vol. 61, p. 663, 1913. 



61 Chamtemesse. International Congress of Hygiene, Berl., Sept., 1907 ; 

 Ref. Bull, de I'Inst. Pasteur, Vol. 5, 1907, p. 931. 



