PREVENTION OF ANAPHYLAXIS 205 



impunity. In man sensitisation rarely if ever attains 

 such a degree as to react with 1 c.c. of serum. If, there- 

 fore, 0-5-1 c.c. be injected subcutaneously, the ordinary 

 dose may be injected with impunity five or six hours 

 later. If immediate treatment is necessary, such a pre- 

 liminary injection may be followed five or ten minutes 

 later by a larger dose and every five minutes or so after- 

 wards by steadily increasing amounts. In this way large 

 amounts of serum may be given in a comparatively short 

 time without giving rise to anaphy lactic shock. 



In the case of prophylactic doses of tetanus antitoxin, 

 these will usually amount to 3-5 c.c. of serum, and sensi- 

 tisation will not be induced thereby until an interval of 

 over five weeks. 



Lumiere and Chevrotier state that the addition of a 

 small amount of sodium hyposulphite to the serum pre- 

 vents the occurrence of anaphylaxis. 1 



On the serum disease, supersensitisation, and anaphylaxis, see 

 Hewlett, Serum Therapy, ed. 2, 1910 ; Kosenau and Anderson, 

 Journ. Amer. Med. Assoc., 1906, p. 1007 ; Von Pirquet and Schick, 

 Die Serum -Krankheit, 1905 ; Richet, Ann. de Vlnst. Pasteur, xxi, 

 p. 497, and Anaphylaxis (Constable & Co., 1913. Bibliog.); 

 Besredka, Ann. de Vlnst. Pasteur, xxi, p. 950, and Bull, de Vlnst. 

 Pasteur, vii, 1909, p. 721 ; Currie, Journ. of Hygiene, vol. vii, 1907, 

 pp. 35, 61, and vol. viii, 1908, p. 457; Griinbaum, ibid. vol. viii. 

 1908, p. 9 ; Goodall, ibid. vol. vii, 1907, p. 607 ; Bordet, Journ. 

 State Med., 1913, p. 449 ; Trans. XVIIth Internal. Cong, of 

 Medicine, 1913, Sect. IV, Pt. I, pp. 1 (Besredka) and 13 (Richet), 

 and ibid. Pt. II. (Friedberger) ; Wyard, Lancet, 1917, vol. i, 

 p. 105. 



ANTI-MICBOBIC SERA : BACTERIOLYSIS. The majority 

 of the pathogenic micro-organisms produce no extra- 

 cellular toxin, and antitoxic sera cannot, therefore, be 

 prepared for them. If, however, the organisms them- 

 selves be injected with care, the animal gradually becomes 



1 Acad. des Sciences, Paris, Seance, Oct. 18, 1920. 



