i9, e Lantin: Methods of Serum Application 635 
method on collapsed patients, as the veins are also collapsed. 
In my collapsed cases the open method was resorted to. The 
reaction following intravenous injection was mild; usually there 
was a chilly sensation lasting from thirty to sixty minutes, 
accompanied by rise in temperature, with slight acceleration of 
pulse and respiration. The reaction may last from ten to fif- 
teen minutes, followed by thirst and general weakness. The 
temperature may fall by crisis or by lysis after the next twelve 
hours. 
DISCUSSION 
The main point that I would like to emphasize in the treat- 
ment of bacillary dysentery is the early and broad application of 
the biological products whenever possible. In an acute disease 
like this one, early application of specific therapy is imperative 
on account of the definite pathological lesions taking place pro- 
gressively in the large intestines, and because of the severe 
toxaemia that arises after absorption of the toxins. It should be 
given even to cases in which there is suspicion of bacillary 
dysentery, without waiting for the results of the bacteriological 
examination. This is highly advisable in cases of infection in 
children, for they have lower powers of resistance, and they 
die comparatively sooner than adults. The earlier the serum 
is given the better, as frequently very good results follow early 
treatment. 
It has been observed by those who have studied the disease 
carefully that the toxins of the organisms act selectively on the 
mucosa of the large intestine. Injections of dysenteric toxins 
into susceptible animals produce similar symptoms, as well as 
the specific pathological changes in the large intestine, that are 
observed in human beings. This agrees with the observations 
of Shiga, Flexner, and Sweet and Doerr. Doerr(3) was able 
to save the life of an animal, after administering a lethal dose 
of the dysenteric toxin, by a previous injection of serum. 
Similar observations by Todd, Vaillard, and Dopter confirm 
their findings. Shiga, (9) the pioneer in this field, states that 
dysenteric serum is bactericidal as well as antitoxic. 
In view of the established facts, set forth by qualified observ- 
ers, the local use of the serum seems to my mind not to 
be unscientific. Considering well the morbid changes in the 
large intestine, where acute inflammation and ulceration are 
taking place, and recalling that that is the site where the virus 
flourishes best, continuously elaborating the toxins, we can 
