THE STANDARDIZATION OF TETANUS ANTITOXIN 
[An American unit established under authority of the act of July 1, 1902.] 
By Milton J. Rosenau, 
Surgeon, Director Hygienic Laboratory , U. S. Public Health and Marine- Hospital Service, 
and 
John F. Anderson, 
Passed Assistant Surgeon, Assistant Director Hygienic Laboratory, JJ. S. Public Health 
and Manne- Hospital Service. 
INTRODUCTION. 
There are now four methods of measuring the strength of tetanus 
antitoxin: (1) The German method described by Behring, (2) the 
French method of Roux, (3) the Italian method after Tizzoni, and 
(4) the American method described in this bulletin. 
The European standards are admitted to be unsatisfactory and, 
for the most part, not accurate; further, they are complicated and 
difficult to carry out. The American method adiopted officially under 
the laxy of July 1, 1902, for this country is the result of seyeral years, 
xyork upon this subject in the Hygienic Laboratory and it is belieyed 
will commend itself for its simplicity, directness, and accuracy. 
The standard toxines and antitoxins are preseryed under special 
precautions to preyent deterioration and are tested against each 
other reciprocally, so that the least alteration in either may be 
detected. 
'Wliile the unit is based upon the neutrahzing yalue of an arbitrary 
quantity of antitoxic serum, the antitoxin is not issued to other labo- 
ratories for the purposes of test, as is the case with diphtheria. A 
stable precipitated tetanus toxine, the test dose of xyhich has been 
carefidly determined, is giyen out. All the tetanus antitoxic serums 
for use in man upon the American market are now measured against 
this same standard toxine and haye therefore precisely comparable 
strengths. 
The need of uniformity in standardizing this yaluable prophylactic 
serum is eyident from the table on page 11, from xxdiich it will be seen 
Manuscript submitted for publication March 4, 1908. 
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