400 BACTERIOLOGY. 
methods. Some speak well of it. No bad results have 
followed the injections when the serum was sterile and 
the operation was performed aseptically. 
The Dosage of Tetanus Antitoxin. For immunization 
10 c.c. of a serum of a strength of 1:1,000,000,000 
will suffice unless the danger seems great, when the 
injection is repeated at the end of a week. For treat- 
ment, it is well to begin with 50 c.c., and then, accord- 
ing to the severity of the case, give from 20 to 50 cc. 
each day until the symptoms abate. In the gravest 
cases no curative effect will be noticed from the serum. 
Though these few cases are not sufficient to form a 
final judgment of any treatment, Lambert concludes 
that by means of the antitoxin treatment, combined 
with other rational methods, the prognosis, even in 
acute cases of tetanus, has been improved; but that 
it still remains exceedingly grave—so much so that 
the preventive inoculation of serum in all cases where 
dirt has been ground into serious contusions de- 
serves a much more extensive consideration than has 
heretofore been given it. The striking results which 
have been obtained, particularly in veterinary practice, 
with the prophylactic injection of tetanus antitoxin, 
would seem to warrant the treating of patients with 
immunizing doses of serum—at least in neighborhoods 
where tetanus is not uncommon—when the lacerated 
and dirty condition of their wounds may indicate the 
possibility of a tetanus infection. 
Differential Diagnosis. The differential diagnosis of 
the bacillus of tetanus is, generally speaking, not diffi- 
cult, inasmuch as animal inoculation affords a sure test 
of the specific organism. No other micro-organism 
known produces similar effects to the tetanus bacillus, 
