STREPTOCOCCUS PYOGENES. 493 
Double the fatal dose of a culture which kills only 
in a dose of 10 ¢.c. or over is a more severe test than 
a thousand times a very virulent one. 
It is entirely different in case of an antitoxin 
which does not prevent primarily the growth of the 
germ, but neutralizes a chemical snbstance—its toxin. 
Its Therapeutic Results. To estimate the exact pre- 
sent and future value of antistreptococcus serum is a 
matter of the utmost difficulty. Many of the cases 
reported are of little or no help, because, on account of 
no cultures having been made, we are in doubt as to the 
nature of the bacterial infection. Even when bacterio- 
logical examinations are made during life in cases of 
septicemia, they are apt to fail to give us any informa- 
tion. Under Marmorek’s supervision many cases have 
been injected; thus, even as far back as June, 1895, 
when his last statistics were published, he had treated 
96 cases of scarlet fever, 411 cases of erysipelas, 16 
cases of puerperal fever, and smaller numbers of cases 
of tonsillitis and of post-operative septicaemia. 
Since then he has treated many forms of phthisis. 
In all these cases marked improvement is reported to 
have followed when they were due to streptococci. 
Thus, in sixteen cases of puerperal fever seven were 
due to streptococcus alone. All these recovered. 
Three were due to the streptococcus and colon bacil- 
lus and one to the colon bacillus alone. These four 
all died. In five, streptococci were associated with 
staphylococci. Two of these died, three recovered. 
In phthisis where no cavities have as yet appeared 
the fever and sweats lessened and all symptoms im- 
proved. He did not state that any cases were abso- 
lutely cured. Marmorek’s results are by far the best 
reported, and without casting any doubt upon the in- 
