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Scientific Proceedings (121). 



vaccines have no value in the treatment, because of the over- 

 whelming number of typhoid bacilli in the intestinal tract. 



When it was found that the autogenous vaccines were not 

 effective another method had to be devised. As no colon serum 

 had been previously made, Dr. Cotton consulted with Dr. John 

 F. Anderson, who agreed to attempt to immunize a horse with 

 strains isolated in the laboratory at the State Hospital at Trenton. 

 It was found that the colon bacilli, even in small doses, were 

 extremely toxic for the horse, but finally a serum was produced 

 which was very potent. 



As many of the patients were suffering from combined infection 

 of the streptococci and colon bacilli, it was decided to combine 

 these organisms in one serum, merely for the sake of convenience 

 of administering the serum. As noted below, this serum has 

 proved entirely satisfactory, not only in reducing the surgical 

 mortality, but, combined with the surgical procedure of removing 

 the infected colon, it has apparently hastened the disappearance 

 of the mental symptoms immediately following the operation. 



Hence, the colon-streptococcus anti-serum, prepared from 

 strains furnished by Dr. Cotton, has been given as a pre-operative 

 treatment, in a series of from eight to ten doses, extending over 

 about a month. Without any other change being made in the 

 surgical technique or post-operative care, the mortality dropped 

 to 12 per cent. Autopsy notes show that this decrease was 

 primarily due to a great reduction in the number of perforations 

 which formerly had occurred in the operation area. It has been 

 noted, clinically, that the character of the improvement is transient, 

 probably due to reinfection. 



This series of one hundred and seventy cases of colectomy is 

 too small to permit of any definite deductions as to the value of 

 this serum, and this report is merely a provisional one, the en- 

 couraging nature of which may not be supported by subsequent 

 studies. 



