THE CORNEA 333 



Bordone and Uffreduzzi, Kruse, Pansini, and others, used attenuated or dead 

 cultures ; Foa and Scarbia used bacterial extracts ; Netter, Vassale, Montanaro, 

 and Klemperer introduced pneumococcal exudations and affected organs ; Emmerich 

 and Wassermann introduced small quantities of very virulent cultures. Combina- 

 tions of these methods have been used. Others (Klemperer, Bonome, etc.) injected 

 nitrates of cultures or tissues, following Kitasato and Behring. who obtained, with 

 such filtrates, practical degrees of immunity to diphtheria and tetanus. It was 

 soon obvious that the conditions were quite different in the case of the Pncumo- 

 coccus, and that this last method (with filtrates) would lead to no results of value, 

 as the active substances lay in the bodies of the bacteria. The method, therefore, 

 will not be discussed. 



The results which the various observers obtained with the active method 

 mentioned did not quite agree ; the degree of the immunity, its time of entrance, 

 and its duration, were influenced to a varying extent by variations in the virulence 

 and the strains of the cocci. 



Soon after the discovery of passive immunity in diphtheria, Emmerich and 

 Fawitzky, Bunzel and Federn, Foa and Carbone, F. and G. Klemperer, commenced 

 experiments in the year 1891 to passively immunize animals against Pneumo- 

 cocci by the use of the serum of other immunized animals. Emmerich used the 

 serum of rabbits, so highly immunized by the intravenous injection of very diluted 

 highly virulent Pneumococci, that they were able to withstand 25 to 80 c.em. of 

 a highly virulent bouillon culture. With the serum of these animals he obtained 

 a certain amount of curative action on animals already infected. 



Foa and Carbone made the first attempts at the treatment of pneumonia 

 patients, and they attempted to immunize animals with the serum of a convales- 

 cent from pneumonia. They observed that an immunity against all the varieties 

 of Pneumococcus could not be produced with the one strain. 



G. and F. Klemperer report attempts at treatment with their serum. 



This curative action of rabbit's serum for pneumococcal diseases in man was not 

 confirmed by many observers, and, considering the variable course of these diseases, 

 especially pneumonia, the apparently favourable results are not convincing. This 

 method of treatment was, at any rate, unable to make further progress. 



Washbourn, with others, utilized the power of a serum to make the Pneumococci 

 in a tube sink to the bottom as a measure of its activity. He obtained better 

 results by using the larger animals, especially horses, for the purpose of obtaining 

 serum. Since then Mennes and Pane have used goats, cows, and donkeys. These 

 animals were inoculated with very dilute, highly virulent Pneumococci. Pane 

 especially obtained exceedingly high immunization in rabbits by the intravenous 

 injection of donkey's serum. 



During the nineties attempts were made on many sides to cure pneumonia by 

 the injection of Pane's and other similarly prepared sera. Amounts from 10 to 

 150 c.cm. were used, and the exhibition of very large doses appeared useful. Many 

 reports were favourable (Pane, Fanoni, de Renzi, Eyre and Washbourn, Janson, 

 Pignatti, Goldsborough) ; others were less so (Canteiri, Spolverini, Sears, Hughes 

 and Carter, Bautin, Pieraccini, Huber, Blumenthal). Snivelly collected from the 

 literature 106 cases, and Goldsborough 395, some of which were treated with 

 Pane's serum and some with the serum of pneumonia convalescents. The series 

 only gave a mortality of 5 per cent. Both the authors express satisfaction with 

 this result. 



In spite of this, Weichselbaum came to the conclusion at the end of his critical 

 monograph (1903) that, considering the variations in the course of a pneumonia, 

 and the fact that it often heals spontaneously, the curative action attributed to the 

 serum could only be demonstrated when a still larger number of cases was tested. 



