A manual of bacteriology, clinical and applied / by Richard T. Hewlett.

  • Hewlett, R. Tanner (Richard Tanner), 1865-1940.
Date:
1898
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Licence: Public Domain Mark

Credit: A manual of bacteriology, clinical and applied / by Richard T. Hewlett. Source: Wellcome Collection.

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    toxins, and antitoxin treatment is therefore somewhat disappoint- ing. Another essential condition is the administration of a suffi- cient amount of antitoxin, and this does not depend on the actual volume of serum injected. The antitoxic serum may be regarded as a solution containing a variable amount of antitoxin, and for therapeutic use its strength—that is, the amount of antitoxin present—must be ascertained. The strength of an antitoxic serum is for convenience described in arbitrary units, a unit being that amount of the serum which will completely neutralise ten lethal doses of a toxin injected into a 260-gramme guinea-pig. The close of antitoxin is dependent upon the gravity of the disease, and not on the age of the patient, for a slight considera- tion will show that just as much toxin may be formed in a child as in an adult. It has been found impracticable hitherto to separate the antitoxic constituent from the serum, so that atten- tion has recently been directed to obtaining as strong an anti- toxic serum as possible in order that the dose may be reduced in volume, and the diphtheria antitoxin can now be obtained con- taining the 1500 units in as little as 3 or 4 c.c. In addition to antitoxin, general and local treatment should be pursued as usual in those diseases in which it is applicable, for antitoxin has no direct action on the bacteria which produce the disease. The antitoxins are strictly specific ; diphtheria antitoxin, for example, has not the slightest influence in tetanus. In cases of mixed infection, where the diphtheria bacilli are associated with streptococci or staphylococci, the diphtheria antitoxin may prove of less value, as it will have no influence on the streptococcic or staphylococcic infection. Likewise septi- caemia and puerperal fever may be due to a variety of organisms, streptococci, staphylococci, bacterium coli commune, &c, but the anti-streptococcic serum is only of value when the infection is due to the streptococcus. The complications and accidents of antitoxin treatment are few and usually unimportant. Abscess and other local troubles at the seat of inoculation should not occur if proper antiseptic precautions be taken. Urticaria or other rashes and joint pains are by far the most troublesome complications. At present these seem unavoidable and are to be treated on general principles, but