followed by good results, especially in the bacillary form of dysentery, if combined with the aperient sulphates.
Antiserum*[1] — In bacillary dysentery the intravenous or subcutaneous injection of massive doses (20 to 40 c,c.) of antidysenteric sera has been followed by good results, especially in fulminating cases when collapse, due to absorption of the toxins of the bacillus, has occurred.
A polyvalent serum— that is the serum of a horse immunized against various strains of Bacillus dysenteriœ— has given the best results. Such sera are Vaillard and Dopter's, Shiga's, and that of the Lister Institute. The Lister Institute's serum is prepared by injecting a combination of Shiga's, Kruse's and Flexner's original strains, bacilli from El Tor, from asylum dysentery and from infantile diarrhœa. As much as 320 c.c. of this antiserum has been given intravenously within twenty-four hours in desperate cases. In children under 10 years of age 10 c.c. or less is a sufficient dose. The injection is made with a Roux syringe into a large vein, and is not followed by any untoward results. Serum treatment should be combined with the general treatment, including intestinal antiseptics and aperient salines. The combination of these three modes of treatment appears to be a rational one. Willmore and Savage report excellent results from El Tor from this line of treatment, and Bahr in Fiji by similar methods reduced the mortality to under 2 per cent, as compared with 13'2 per cent, of a parallel series of cases treated by aperient sulphates alone.
Roux recommends the injection of antiserum as a prophylactic in bacillary dysentery.
In urgent cases in -which collapse symptoms are manifest, and where there is no time for a differential diagnosis, it is advisable to combine the emetine and antiserum treatment.
In cases of extreme exhaustion, occasioned by loss of fluid and straining at stool, continuous transfusion
- ↑ * The antiserum is put up m phials of 20 c.c. each, which is the usual dose for an adult.
