280 MICROBES AND TOXINS 



and 1907 Vaillard and Dopter applied the serum in 512 acute 

 cases of all ages, of whom 32 had certainly fatal dysentery 

 and 170 a very severe attack. The average death rate was 

 only 1-3 per cent., whereas in different epidemics it has varied 

 from 10 to 25 or 50 per cent. The serum relieves the patients 

 of their terrible abdominal pains, of the vomiting, and of the 

 hiccough ; the stools become less numerous and less painful, 

 the temperature falls, and a feeling of comfort succeeds that 

 of absolute, prostration. These good results occur as a rule in 

 the course of one day. 



The antimeningococcus serum of Flexner is employed 

 in epidemic cereliro-spinal meningitis. It has hardly any 

 action when injected subcutaneously. It must be injected at 

 the site of the disease — i.e., into the cerebro-spinal canal by 

 lumbar puncture. The treatment should be begun as soon as 

 possible and be repeated. It has lowered the mortality from 

 60 to 80 per cent, to 25 to 10 per cent. 



Antistreptococcic serum is a polyvalent serum — i.e., it 

 is prepared with several strains of streptococci. It is difficult 

 to get an accurate idea of its efficacy in man. The infections 

 in which streptococci are responsible are multiple, and the 

 serum is employed in the most diverse diseases, from puerperal 

 fever to scarlatina and acute rheumatism. Large quantities of 

 this serum are supplied from the Pasteur Institute both for 

 medical and veterinary use, but unfortunately it is rare to get 

 any information as to the results obtained. 



Antituberculous Sera. — Maragliano's serum is supplied 

 by horses treated with the soluble constituents of the tubercle 

 bacillus. 



Marmorek's serum is furnished by horses immunized 

 with "primitive bacilli," i.e., young bacilli which scarcely 

 possess any of the acid-fast property due to the wax and fat 

 constituents. The same horses are at the same time im- 

 munized against streptococci, since the streptococci are 

 frequently associated with Koch's bacillus in tuberculous 

 lesions. As regards this serum opinions differ. Certain 

 observers report a favourable action on cases of tuberculosis of 



