SERUM THERAPY 97 



tetanus. Its use, however, must be thoroughly 

 understood in order to achieve satisfactory re- 

 sults. It must be administered before the ad- 

 vent of symptoms of the disease; for, after the 

 tetanus toxin has combined with the motor 

 nerve cells in the central nervous system, it can- 

 not be displaced or neutralized with antitoxin. 

 Reliability of Antitoxin The reliability of 

 Tetanus Antitoxin as a prophylactic measure is 

 admirably shown in the statistics published by 

 H. J. Scherck, Chief of the St. Louis Health 

 Department (The Journal A. M. A., 1906, 

 XLVII, 500), in which he reported a series of 

 291 injuries by toy pistols and other Fourth-of- 

 July injuries. These cases were immunized 

 with Tetanus Antitoxin and not a single person 

 developed tetanus. This series of cases ex- 

 tended over a period of three years, and a com- 

 parison of these results with those obtained in 

 another year when no antitoxin was used showed 

 that nearly one-third of the injured succumbed 

 to tetanus. Moreover, it has been conclusively 

 shown that when the antitoxin is injected as late 

 as 96 hours after the injury, it proves a reliable 

 prophylactic against the development of the 

 disease. It is the custom at many dispensaries 



