426 



SCIENCE. 



[N. S. Vol. IV. No. 91. 



Lille, and Fraser, of Edinburgh, have 

 shown that antidotes of wonderful efficacy 

 against the venom of serpents may be pro- 

 cured on the same principle. Calmette has 

 obtained antitoxin so powerful that a quan- 

 tity of it only a 200,000th part of the 

 weight of an animal will protect it perfectly 

 against a dose of the secretion of the poison 

 glands of the most venomous serpents 

 known to exist, which, without such pro- 

 tection, would have proved fatal in four 

 hours. For curative purposes larger quan- 

 tities of the remedy are required, but cases 

 have been already published by Calmette 

 in which death appears to have been avert- 

 ed in the human subject by this treatment. 



Behring's darling object was to discover 

 means of curing tetanus and diphtheria in 

 man. In tetanus the conditions are not 

 favorable ; because the specific bacilli lurk 

 in the depths of the wound, and only 

 declare their presence by symptoms caused 

 by their toxin having been already in a 

 greater or less amount diffused through the 

 system ; and in every case of this disease 

 there must be a fear that the antidote may 

 be applied too late to be useful. But in 

 diphtheria the bacilli very early manifest 

 their presence by the false membrane which 

 they cause upon the throat, so that the 

 antitoxin has a fair chance ; and here we 

 are justified in saying that Behring's object 

 has been attained. 



The problem, however, was by no means 

 so simple as in the case of some mere chem- 

 ical poison. However effectual the anti- 

 toxin might be against the toxin, if it left 

 the bacilli intact, not only would repeated 

 injections be required to maintain the tran- 

 sient immunity to the poison perpetually 

 secreted by the microbes, but the bacilli 

 might, by their growth and extension, cause 

 obstruction of the respiratory passages. 



E.OUX, however, whose name must alwaj^s 

 be mentioned with honor in relation to this 

 subject, effectually disposed of this diffi- 



culty. He showed by experiments on ani- 

 mals that a diphtheritic false membrane, 

 rapidly extending and accompanied by sur- 

 rounding inflammation, was brought to a 

 stand by the use of the antitoxin, and soon 

 dropped off, leaving a healthy surface. 

 Whatever be tlie explanation, the fact was 

 thus established tliat the antitoxic serum, 

 while it renders the toxin harmless, causes 

 the microbe to languish and disappear. 



IS'o theoretical objection could now be 

 urged against the treatment; and it has 

 during the last two years been extensively 

 tested in practice in various parts of the 

 world, and it has gradually made its way 

 more and more into the confidence of the 

 profession. One important piece of evi- 

 dence in its favor in this country is derived 

 from the repoi't of the six large hospitals 

 under the management of the London 

 Asylums Board. The medical officers of 

 these hospitals at first naturally regarded 

 the practice with scepticism, but as it ap- 

 peared to be at least harmless they gave it 

 a trial ; and during the year 1895 it was 

 very generally employed upon the 2,182 

 cases admitted, and they have all become 

 convinced of its great value. In the nature 

 of things, if the theory of the treatment is 

 correct, the best results must be obtained 

 when the patients are admitted at an early 

 stage of the attack, before there has been 

 time for much poisoning of the system, and 

 accordingly we learn from the report that, 

 comparing 1895 with 1894, during which 

 latter year the ordinary treatment had been 

 used, the percentage of mortality, in all the 

 six hospitals combined, among the patients 

 admitted on the first day of the disease, 

 which in 1894 was 22.5, was only 4.6 in 

 1895 ; while for those admitted on the sec- 

 ond day the numbers are 27 for 1894 and 

 14.8 for 1895. Thus for cases admitted on 

 the first day the mortality was only one- 

 fifth of what it was in the previous year, 

 and for those enterinsc on the second it was 



