﻿438 



STRONG. 



on the part of the patient occurred. The average amount of serum 

 given was from 300 to 500 cubic centimeters, but in one case 1,000 cubic 

 centimeters were inoculated in twenty-four hours. The cases in the hospi- 

 tal were treated alternately with serum, that is, every other case admitted 

 received this treatment. Dr. Denier remained at the hospital day and 

 night and was indefatigable in his efforts to treat and care for the sick. 

 The injections of the serum were usually given very shortly after the 

 time of the admission of the case to the hospital. Obviously, the patients 

 were frequently in collapse at the time of their arrival. Dr. Denier 40 

 has prepared the following table which at a glance shows the results of 

 the serum treatment. 





Number 

 of cases. 



Cholera 

 spirillum 

 not iso- 

 lated 

 from the 

 stools. 



Dead. 



Recov- 

 ered. 



Percent- 

 age 

 of mor- 

 tality. 



Controls _ 



21 



16 



5 



3 



1 



13 



11 



2 



5 

 4 

 3 



72 

 75 

 40 



Serum "A" antitoxic 



Senim "TJ" nTitimirrohir 









From this table it is evident, as Denier points out, that the cases 

 which received the antitoxic serum were not benefited by it, the mortal- 

 ity being even higher than in the ones which received no serum. The 

 number of cases which received the antimicrobic serum is too small to 

 justify decided conclusions, although the mortality is much lower. 

 Denier calls attention to the fact that liquid and frequent serous move- 

 ments occurred shortlv after the inoculations, with the patients who 

 received intravenously a large amount of the serum in Hayem's fluid, 

 these movements in volume approximately equaled that of the liquid 

 injected. Therefore, he thought that possibly the antitoxic serum was 

 not retained in the body for a sufficient length of time to accomplish its 

 action and that it was perhaps excreted into the intestine and passed in 

 the stool. He suggests that the injection of the serum might therefore, 

 under proper aseptic conditions, be made with better -results into the 

 abdominal cavity. It has occurred to me that, if the inoculated serum 

 was excreted into the intestine, more favorable results might perhaps be 

 obtained, at least in the early cases, with a serum of higher bacteriolytic 

 power, since, in the event of the excretion of the serum by the mucosa of 

 the intestine, it would be brought into direct contact with the cholera 

 spirillum. Probably such a serum would exert no favorable influences 

 by its bacteriolytic properties in the later stages of the disease. It would 



40 Report a Monsieur le Gouveneur General de l'lndo-Chine, Hanoi.. Saigon, 

 Oct. (1906.) 



