WOUND INFECTION 101 



We obviously cannot bring any certain proof that such injections 

 have protected any individual case. I have never had a pneumococcal 

 infection in an immunized patient. In estimating the value of the 

 protective power which we thus desire to produce, it would be of 

 special value if cases of pneumococcal suppuration in patients thus 

 treated with serum were to be observed. 



An intra-ocular pneumococcal suppuration, ichen already developed, 

 either in experimental or clinical cases, is not influenced at all by any 

 serum treatment yet devised. 1 



Rymowicz's 2 results with the more commonly applied streptococcal 

 immunity are rather more favourable. He immunized the cornea by 

 previous serum injections. Simultaneous injections caused a corneal 

 infection to heal up slowly ; later injections had no effect. Previous 

 injections alone protected against infections of the anterior chamber. 

 Previous immunization had a very doubtful influence on eyes which 

 were infected after the lens had been extracted. No curative action 

 could be obtained in such cases by later injections. Streptococcal 

 serum is much less often useful in cases of wound infection. Such 

 prophylactic measures were recommended in 1896 by Boucheron (Soc. 

 de Biologic, April, 1896). Rogrnan, Angelucci, 3 and Attanasio, 4 re- 

 commend injections of pneumococcal or streptococcal serum in all sus- 

 picious cases. (This should certainly be done, on account of the 

 danger of a general infection, in severe conjunctival or corneal lesions 

 due to Streptococci.} 



Rymowicz had analogous results with staphylococcal serum ; but 

 Paltschikowski 5 was quite unable to modify staphylococcal infection of 

 the anterior chamber by immunization. 



Loffler, working with chicken cholera, and Eomer with Pneumococci, 

 have experimentally shown that the cornea participates not only in 

 any general antitoxic immunity e.g., against diphtheria toxin 

 (Romer) but also in an antibacterial immunity. It was possible by 

 active, passive, or simultaneous immunization, to protect the cornea 

 against anything less than a very large dose of virulent Pneumococci. 

 A curative action, was, indeed observed in animals, but to a much less 

 degree than the prophylactic. On this Eomer based a serum-prophy- 

 laxis and a serum treatment of pneumococcal infection of the cornea, 

 especially the ulcus corneae serpens. This affection should here be 

 noticed, as it usually results from the infection of small corneal 



1 Axenfeld, ' Serumtherapie iufektioser Augenerkrankungen,' Freiburg, 1905 (U. Hoch- 

 reuther), p. 76. In the future larger doses must be tried. 



2 Wjestnik Oftal., 1903, Xos. 4, 5. 3 Arch, di Ottal., 1902, x. 79. 

 4 Ibid., 1902, ix. 401. 5 Quoted by A. Leber, loc. cit. 



