An American text-book of surgery : for practitioners and students / By Phineas S. Conner, M.D., Frederic S. Dennis, M.D., William W. Keen, M.D., Charles B. Nancrede, M.D., Roswell Park, M.D., Lewis S. Pilcher, M.D., Nicholas Senn, M.D., Francis J. Shepherd, M.D., Lewis A. Stimson, M.D., J. Collins Warren, M.D., and J. William White, M.D. Ed. by William W. Keen and J. William White.
- William Williams Keen
- Date:
- 1899
Licence: Public Domain Mark
Credit: An American text-book of surgery : for practitioners and students / By Phineas S. Conner, M.D., Frederic S. Dennis, M.D., William W. Keen, M.D., Charles B. Nancrede, M.D., Roswell Park, M.D., Lewis S. Pilcher, M.D., Nicholas Senn, M.D., Francis J. Shepherd, M.D., Lewis A. Stimson, M.D., J. Collins Warren, M.D., and J. William White, M.D. Ed. by William W. Keen and J. William White. Source: Wellcome Collection.
Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.
![and antitoxic properties develop in tlie blood during its acquisition. The horse is the animal which is used, and the amount of antitoxin developed may be so great that .2') c.c. of serum will neutralize toxin sufficient for 40.000 fatal doses. Though this power is very great when the toxins and antitoxic serum are mixed in vitro (in a glass dish), yet the ability to check the disease diminishes ra])idly as time goes on. This is possibly to be explained by the theory that the toxin combines with certain cells of the body, particularly with the neuron, and this union gradually becomes firmer and firmer, and the antitoxin, therefore, is unable to neutralize the toxin, as it has undergone chemical change. To secure success a large quantity, 100- 200 CO.. of serum should be injected at the earliest possible moment. Its intra-cerebral injection after trephining is the latest method of using it, but this method is too recent to make any autiioritative statement as to its value. The mortality in severe acute cases probably has not been diminished by the use of antitoxin, but it would seem as though in chronic cases more favorable results were obtained than before its introduction, Lambert having collected 61 chronic cases treated with the serum, with a mortalit}^ of 16.4 per cent., instead of 40 per cent., the average mortality in chronic cases heretofore. This serum can be obtained from the Boards of Health of several States and from some manufacturers. Anthrax.—Although the toxin of the anthrax bacilli has received a great deal of attention, and the induction of artificial immunity has been successful to a large degree, nevertheless but little j)rogress has been made in its orrho- therapy, and even uniform laboratory results have not been obtained. By various methods of attenuation, as, for example, growing the anthrax cultures at unfavorable temperatures, protective vaccines have been produced which have ffreatlv diminished the mortalitv in cattle from anthrax. Thus in twelve years in France there were 1,788.677 sheep and 200.902 cattle inoc- ulated, with a mortality, including deaths from the inoculations, of .94 per cent, for the sheep and .34 per cent, for the cattle, against a mortality of about 10 per cent, for sheep and 5 per cent, for cattle previous to the intro- duction of protective inoculations. Streptococcus.—Marmorek has obtained a serum from horses immu- nized with streptococcus cultures, which, though toxic if drawn during the time that the injections are being practised, becomes protective after a period of about four weeks. With this serum some, though by no means constantly, favorable reports have been obtained in streptococcus septicemia. The ques- tion is an open one whether the good results did not arise from the simple stimulative action of the horse-serum upon the tissue-cells, especially as equally favorable results have come from the use of this serum in cases in which there were probably no streptococci present. The .still unsolved question, whether all the various forms of streptococci with pyogenic properties are practically one and the same or are varieties having di.stinct toxins, adds much to the difficulties in the way of the solu- tion of the problem of streptococcic diseases. Staphylococcus.—But little, and for the most part contradictory, work has been done with this organism, and the work has not yet passed the labor- atory-stage. The blood of animals treated with the toxin is said to be both bactericidal and antitoxic, if obtained several weeks after the treatment. The difficulty in the way of the solution of this problem seems to lie in the absence of any immunity conferred by this organism upon the human subject. Bubonic Plague.—Horses react vigorously to the action of the poison,](https://iiif.wellcomecollection.org/image/b21217014_0119.jp2/full/800%2C/0/default.jpg)
