TREATMENT 245 



not the case, and that it is completely antagonistic only 

 to the specific venom by which it is elicited, namely 

 cobra-venom. Calmette's horse-serum, defibrinated and 

 filtered with aseptic precautions, and portioned out in 

 sterilized bottles of 10 c.c. capacity, is what is commonly 

 known as antivenine. 



The antivenomous sera, or antivenines, originated by 

 Calmette, or modifications of them, are now prepared 

 and issued with directions for use by institutions in 

 several countries. In the discussion of treatment they 

 must take precedence of everything, not because they 

 are, at the present moment, by any means perfectly 

 assured and adapted to universal practice, but because 

 they are based upon principles that are entirely rational, 

 and that promise unimpeachable therapeutic results in the 

 future. 



Considered to begin with merely as instruments : quite 

 aside from difficulties of preparation, which are great 

 and manifold, and apart from their possible instability 

 under ordinary tropical conditions, they are weak. To 

 illustrate this point Martin and Lamb make a very 

 striking comparison between the antitoxins of diphtheria 

 and tetanus on the one hand, and antivenom on the other, 

 showing that volume for volume by respective standard 

 antivenom has only one-ten-thousandth the specific neu- 

 tralizing value of the first, and only one-twenty-thousandth 

 that of the second. This, as they insist, involves the 

 employment of very large volumes of antivenom more 

 than TOO c.c. for an intravenous injection, and very much 

 more for a subcutaneous injection if all the venom that 

 may be absorbed from a bite is to be neutralized. But 

 Calmette, whose idea seems to be not to neutralize or 

 satisfy all the venom that may be injected by a snake, 

 but to " augment the natural resistance " of the tissues, 

 brings forward a good deal of evidence, of a sort, to 

 justify his contention that in cases of cobra-bite a hypo- 

 dermic injection of 10 or 20 c.c. of his antivenom is 

 enough " to cure human beings." 



