TYPHOID SERUM AND VACCINE 427 



Anti-typhoid serum. Attempts have been made to 

 prepare an anti-typhoid serum by inoculating horses with 

 increasing doses of typhoid bacilli, first killed (by heat, 

 chloroform, etc.) and then living, but such sera have 

 proved quite useless for treatment. 



Macfadyen 1 prepared an endotoxic serum by treating 

 horses with the endotoxin obtained by triturating the 

 bacilli in the presence of liquid air. The writer continued 

 the work, and obtained a serum which gave promising 

 results. 2 



Chantemesse 3 prepared a serum by injecting horses 

 with a special ox-spleen broth culture of the typhoid 

 bacillus, which he claimed possessed marked curative 

 power. The patients receive very small doses of the 

 serum five or six drops and the dose is repeated only 

 two or three times. This dosage is quite different from 

 that of an ordinary antitoxic or antimicrobic serum, 

 and Wright suggested that toxins (and not anti-bodies) in 

 serum may be the active agents. Chantemesse accepted 

 this view, and the treatment, therefore, seems to be 

 actually a vaccine one. 



The disease has also been treated with a vaccine (con- 

 sisting of a killed culture) with promising results by 

 Semple, Smallman, Leishman, and others. The initial 

 dose is 40-100 millions, and the amount is cautiously 

 increased up to 300-400 millions. 



Anti-typhoid vaccine,. Wright 4 first employed an anti- 

 typhoid vaccine for prophylaxis, prepared by killing a 

 fourteen to twenty-one-days-old broth culture by heating 

 to 60 C. Leishman now cultivates for about forty-two 



1 Proc. Roy. Soc. Lond., B, vol. Ixxi, 1903, pp. 76 and 351 ; Brit. Med. 

 Journ., 1906, vol. i, p. 905. 



2 See Hewlett, Goodall and Bruce, Proc. Roy. Soc. Med., vol. ii, 1907-08 

 (Med. Sect.), pp. 245 et seq. ; and Hewlett's Serum TJierapy, p. 220. 



3 Trans. Fourteenth Internal. Cong. Hygiene and Demography, 1907. 

 * Wright and Semple, Brit. Med. Journ., 1897, vol. i, p. 256. 



