VACCINES AND SERA 279 



very numerous, the mortality was reduced by about a half. In 

 the laboratories work is still going on towards the improvement 

 and perfection of an anticholera serum. 



Antiplague Serum. — It is derived from horses immunized 

 against the plague bacillus. The treatment is long and difficult. 



The statistics are in need of discussion. Whereas Mayer, 

 for example, records numerous cases of cure, other physicians 

 declare that there are more deaths among the treated than the 

 non-treated : they allege that the serum is too weak and the 

 Hindu too susceptible to plague. When these unfavourable 

 statistics are more closely examined, it becomes apparent that 

 the serum has been given too late, in too small dose, by subcu- 

 taneous injection, and not long enough continued: the patients, 

 abandoned after the fall of the fever, died in many cases 

 fifteen to thirty days after the last serum injection. In man, 

 plague is all over in five to six days, and if treatment is only 

 carried on during the third or fourth day cure is well nigh 

 impossible. 



The injections ought to be massive and repeated. It is no 

 use trying to treat plague with the doses suitable to antitetanus 

 serum.^ 



It is evident that against pneumonic plague the serum which 

 we possess at present is not to be relied on, but that against 

 bubonic plague it has already been of service. It may be of 

 great value in a population where the hygiene is good, to 

 complete the isolation of a case of plague by giving prophylactic 

 injections to the contact individuals, and thus to limit the 

 epidemic focus. 



Antidysenteric serum is given in doses of 20, 80 to 

 100 c.c. — the latter doses in very serious cases where there are 

 pore than 100 motions of the bowel per day. Between 1905 



' Duprat, using doses of 300 c.c, succeeded in curing thirty-eight out of 

 forty-five plague patients treated, a mortality of only 15 per cent. 



Employing intravenous injections (100 c.c. repeated after twenty-four 

 hours), Penna had a mortality of I4'2 per cent, in 200 cases. Ferrari at 

 Sao Sabastiao had only 7 '2 per cent, of fatal cases among forty-four. 

 Ferrari's statistics throw light on the different modes of injection : by the 

 skin, 38 per cent, death-rate, intraperitoneally, 18 per cent, intravenously 

 7 '2 per cent. 



