VACCINATION. IMMUNIZATION. INOCULATION 253 



Curative Vaccination in Tetanus. — The curative action of 

 tetanus antitoxin in tetanus of man was discovered by von Behring 

 in 1896. Since that time it has been frequently employed in 

 veterinary medicine in tetanus of horses. At first its action as a 

 curative agent appeared to be favorable, but later the failures 

 increased to such an extent that it is now used only in isolated 

 cases. In the Prussian army, from 1896 to 1907, 129 horses 

 affected with tetanus were treated with the antitoxin and 85, 

 or 66 per cent., died. During the years previous to the use of 

 the serum the mortality was as follows: in 1881, 55 per cent.; 

 1882, 57 per cent.; 1884, 65 per cent.; 1885, 62 per cent.; 1887, 

 67 per cent.; 1888, 66 per cent.; 1892, 65 per cent. In the light of 

 these figures it cannot be said that the use of the antitoxin in the 

 years from 1896 to 1907 exerted a favorable influence upon the 

 disease. 



Recently, it was announced that the preparations of anti- 

 toxin heretofore used were too weak and that the material had been 

 employed in insufficient quantity. It was also stated that the 

 antitoxin must be injected as early as possible, immediately after 

 the diagnosis is made, preferably intravenously, and the injec- 

 tions repeated until improvement occurs. Sawamura (Bern, 1909), 

 in experiments with rabbits affected with tetanus ascendens endo- 

 neural, found that their life was saved when the antitoxin was 

 injected not later than 17 hours after the appearance of the first 

 tetanic symptom. In order to test the value of this new antitoxin, 

 Frohner obtained 500 c.c. of it from Marburg in the summer of 

 1910. The cost of the 500 c.c. was twenty-five dollars, five dollars 

 per dose (100 c.c). Without selection, the first two cases of 

 tetanus entered in his clinic were treated with the antitoxin accord- 

 ing to the accompanying directions, while the third and fourth 

 cases received no treatment. Both of the horses which received 

 the antitoxin immediately after the diagnosis was made in the 

 first stages of the disease died, while the other two, which received 

 no antitoxin, recovered. From this it would appear that the new 

 antitoxin is not a reliable curative agent in tetanus. 



