xiii, b, 5 Lantin: Serum in Bacillary Dysentery 265 



serum may be previously injected intravenously about six hours 

 before the full dose is given. My dosage was 10 cubic centi- 

 meters every other day, although Sandwith has given 20 

 cubic centimeters (of the Lister Institute preparation) daily to 

 adults and 10 cubic centimeters to children. (6) 



It is not the purpose of this paper to discuss the clinical 

 symptoms of the disease, for these are generally well known. 

 The main point that I wish to bring out is the broader applica- 

 tion in the field of medicine of a therapy based on scientific 

 principles. 



Again I have to state that it has long been definitely known 

 that specific bacteria are the causative factors of this disease 

 and that they produce definite pathological changes, particularly 

 in the large intestine. Observations of those writers who have 

 made careful studies of this disease have led to the conclusion 

 that the toxins act locally and, when absorbed in large amount, 

 produce toxaemia. Experiments on animals support these views. 

 Injection of dysenteric toxins into susceptible animals produces 

 similar symptoms and anatomical changes in the large intestine 

 to those observed in human beings. These are the findings of 

 Flexner and Sweet and of Doerr. (2) Doerr, however, could 

 save the animals from the effects of a lethal dose of toxin by 

 previous injections of serum. Similar experiments were re- 

 ported by Todd and later by Vaillard and Dopter. (2) Sandwith 

 states that serum is both antitoxic and bactericidal. 



In view of the established facts set forth by authentic observers 

 on this subject, the local use of the serum seems, to my mind, 

 not to be unscientific. Considering well the morbid changes 

 in the large intestine, where acute inflammation and ulcerations 

 are taking place, and recalling that it is the site where the virus 

 flourishes the best, continuously elaborating the toxins, we can 

 see at once the working basis of the local application. As it has 

 been found that the serum is both antitoxic and bactericidal, 

 it would mean, then, the neutralization, locally, of the unabsorbed 

 toxins and the decreased vitality of the virus, if not its actual 

 death. 



As to how far these aims are accomplished, I am not yet in 

 a position to state ; but it suffices to say that twenty-four hours 

 after the administration of serum per rectum the patient feels 

 a marked alleviation of the local symptoms. The colicky pain 

 is markedly diminished; the stools may still be very bloody, yet 

 greatly decreased in number; and the temperature is lower. 

 During successive days the stools gradually become less bloody 



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