SERUM THERAPY 117 



Reasons for Failure It is now over twenty 

 years since the first attempts were made to 

 treat a patient suffering from acute lobar pneu- 

 monia by means of a serum. Although it has 

 been impossible to demonstrate any marked 

 lowering of mortality in a large series of cases, 

 yet certain clinical observers have felt that in 

 certain instances the results were striking. Ac- 

 cording to Dr. Rufus Cole, one reason why An- 

 tipneumococcus Serum has not been more ef- 

 ficacious in the past is that it has been admin- 

 istered in too small doses. Experiments by 

 Dochez have shown that there is a maximum de- 

 gree of infection against which no amount of 

 serum, however large, is able to protect. This 

 suggests that, in order to obtain best results 

 from the serum, it should be administered early 

 before the infection has reached too extreme a 

 grade beyond which no amount of serum can be 

 effective. These experiments also afford a pos- 

 sible explanation as to why in certain cases 

 serum seems to have absolutely no effect. Ac- 

 cording to Forchheimer, there are cases of 

 pneumonia in which no therapy is of use : these 

 cases are fatal from the beginning, being over- 

 whelmed by toxemia and associated infiltration. 



