xiii, b, 5 Lantin: Serum in Bacillary Dysentery 267 



the serum is given, the patient, formerly restless, becomes quiet, 

 the temperature gradually falls, the colicky pains and tenesmus 

 are less severe, and the stools are diminished in number. These 

 results may be observed after from twenty-four to forty-eight 

 hours. In case of callapse, which is present frequently in severe 

 cases, the pulse becomes fuller and stronger a few hours after 

 injection. There is marked abatement of subjective symptoms 

 on the following days. In my experience it seems that the com- 

 bination of intramuscular administration and serum enemata in 

 acute cases is advisable, for we combata the disease from two 

 sides, namely, (a) neutralization of the toxins in the blood and 

 (b) direct action of the serum on the bacteria and their poisonous 

 products in the lower part of the large intestine. The response 

 of the different patients to administration of serum is shown' in 

 fig. 1 (case 8) and in fig. 2 (cases 12 and 13). 



The action of the serum introduced intravenously is similar 

 to that of the intramuscular administration, but the effects are 

 more rapid, as shown in fig. 1 (case 18). In the three cases 

 that I treated intravenously with serum, one case was of one 

 day's duration before treatment, and the results are seen in 

 fig. 1 (case 18). In the other two cases, in which the duration 

 of the disease was ten days before treatment, the effect of the 

 serum was not so rapid as in the early case; the temperature 

 fell, and the abdominal pain and tenesmus were diminished, but 

 the frequency of bowel movements was only slightly affected. 

 The reaction following the intravenous injection is mild. Out 

 of three cases one felt a slight chilly sensation beginning forty 

 minutes after injection and lasting only for ten minutes. 



The intravenous injection should be made with caution. It is 

 not improbable that serum may produce embolism under certain 

 conditions. 



So far as it was possible to gather from the available statistics 

 on the rate of the mortality in bacillary dysentery treated with 

 drugs as compared with the mortality in cases treated with 

 serum, the following data show the observations of other 

 investigators. 



a. Cases treated with drugs: 



Philippine General Hospital, (5) fiscal year 1912-1913 — 

 Males, 191 with mortality of 17.8 per cent. 

 Females, 75 with mortality of 20 per cent. 

 Other hospitals (5) — 



Japan, 16.5 to 30.2 per cent mortality. 

 Singapore (1902), 25.4 per cent mortality. 

 Ceylon (1903), 28.7 per cent mortality. 



