762 
Biological  Products. 
Am.  Jour.  Pharm. 
Nov.,  19 18. 
opportunity,  followed  by  three  other  injections  of  500  units  each  at 
intervals  of  a  week,  so  that  2000  units  are  injected  over  a  period  of 
four  weeks.  Our  own  boys  receive  two  injections  of  1500  units 
each,  the  first  injection  being  given  immediately  after  the  wounded 
soldier  is  brought  to  the  first  aid  station,  and  the  other  injection  a 
week  or  two  later.  Injections  of  1,500  units  can  readily  be  made 
because  of  the  highly  concentrated  serum  that  is  being  supplied  from 
American  sources.  By  precipitating  the  antitoxic  substance  and  re- 
dissolving  it  in  physiological  saft  solution  and  standardizing,  1,500 
units  can  be  concentrated  into  as  small  a  bulk  as  five  mils  and,  of 
course,  the  injection  of  so  small  a  bulk  presents  no  difficulties. 
Another  serious  infection  to  which  the  wounded  soldier  is  ex- 
posed is  gas  gangrene.  It  has  been  proved  conclusively  that  gas 
gangrene  is  produced  by  the  Bacillus  W elchii,  named  for  Professor 
Welch,  of  Johns  Hopkins  University,  who  discovered  the  organism. 
The  effects  of  this  bacillus  are  due  to  the  toxin  which  it  generates. 
It  has  been  proved  possible  to  prepare  an  antitoxic  serum  which  will 
combat  infections  of  this  organism ;  in  other  words,  gas  gangrene 
is  being  combated  in  the  same  way  as  tetanus  or  diphtheria,  both 
of  which  are  due  to  the  formation  of  toxins  and  for  both  of  which 
there  are  antitoxic  serums.  A  so-called  dual  purpose  serum  is  now 
being  prepared  which  will  contain  in  the  small  bulk  of  ten  mils,  1,500 
units  of  tetanus  antitoxin  and  ten  units  (American  standard)  of  gas 
gangrene  antitoxin.  This  is  the  first  protective  dose  administered 
to  wounded  soldiers  to  prevent  both  lockjaw  and  gas  gangrene. 
Prevention  of  Typhoid  Infections. — Typhoid  has  been  eliminated 
in  our  armies  by  prophylactic  vaccination.  In  the  Spanish- American 
War  we  lost  2,7/14  men  from  typhoid  alone.  If  the  same  percent- 
age were  to  become  infected  with  the  disease  during  the  present 
war  our  casualty  list  up  to  April  1,  1918,  would  number  more  than 
217,000  from  this  disease  alone.  All  this  has  been  avoided  by  the 
simple  expedient  of  injecting  each  man  with  the  triple  typhoid 
bacterin,  sometimes  also  referred  to  as  "triple  vaccine,"  beginning 
immediately  after  their  arrival  at  army  camps  and  cantonments. 
The  injections  consisted  of  so-called  typhoid  vaccine,  correctly 
named  mixed  typho-bacterin,  which  is  made  up  of  killed  typhoid  and 
paratyphoid  A  and  B  bacilli.  The  mixed  vaccine  is  used  because  it 
was  found  that  many  men  who  had  been  immunized  against  typhoid 
fever  later  contracted  paratyphoid  fever  caused  by  either  the  para- 
typhoid A  or  B  organism.    The  so-called  "  triple  vaccine  "  includes 
