CHAPTER XIV 

 PRODUCTION AND TESTING OF ANTITOXINS 



DIPHTHERIA ANTITOXIN 



In spite of the great advances in our theoretical knowledge of anti- 

 bodies, gained during the last three decades, extensive therapeutic 

 application has been made of the antitoxins only. Pre-eminent among 

 these from a practical point of view are the antitoxins against diphtheria 

 and tetanus toxin. For diphtheria, careful statistical studies have 

 demonstrated, beyond doubt, the therapeutic value of the serum 

 treatment. Biggs and Guerard, in a general statistical review, ar- 

 rived at the conclusion that the death rate of diphtheria had been re- 

 duced fifty per cent by the use of antitoxin. Approximately the same 

 estimate is made by Dieudonne ' who studied almost 10,000 treated cases. 



Production of Diphtheria Antitoxin. — The methods for producing 

 diphtheria antitoxin vary only in minor technical details. The first 

 requisite for successful antitoxin production is the possession of a strong 

 toxin. The various means of obtaining this are outlined in the section 

 on diphtheria toxin. The toxin used should be of such potency that 

 less than O.OI. cc. will kill a guinea-pig of 250 grams weight in four 

 to five days.^ 



For experimental purposes, goats or sheep may be used for immuniza- 

 tion; for antitoxin production on a large scale, horses have been found 

 to be the most useful animals. The horses should be young, four to 

 six years old, vigorous, and healthy. It is advisable that they be sub- 

 jected to the mallein test to exclude possible infection with glanders. 



The toxin injections are made subcutaneously. Because of the dif- 

 ferences in susceptibility noted in various horses, it is advisable that the 

 first doses of toxin should be either very small or weakened by chemicals 

 or heat, or combined with antitoxin. In the Pasteur Institute in Paris, 

 the small initial dose of toxin (0.5 cc.) is mixed before injection with 

 an equal quantity of Lugol's solution (iodin-potassium iodid solution), 



1 Dieudonne, Arb. a. d. kais. Gesundheitsamt, 1895 and 1897. 

 >Parh, " Pathog. Bacteria and Protozoa," N. Y., 1908. 

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