2. Keratin, Ceratin

Keratin, Ceratin. Resembles protein, but has some of its oxygen replaced by sulphur, being the chief constituent of cattle and horses' hoofs, feather quills, finger-nails, and epidermal surface. Obtained by macerating horny substances 36 hours in pepsin (1), diluted hydrochloric acid (15), water (1,000), to remove all matter soluble in gastric juice, digest at moderate heat the residue in 10 times its weight of 5 p. c. ammonia water until nearly dissolved, filter, evaporate. Occurs in thick scales, yellowish-gray, opaque, soluble in alkalies and strong acetic acid, insoluble in water, alcohol, ether, diluted acetic acid, and acidified pepsin solutions. Used in coating pills - such as are not intended to dissolve in the stomach, but in the duodenum - where concentrated drugs are desired for the intestines, or the use of those incompatible with pepsin and decomposed by stomach's secretions - metallic sulphides, tannin, pancreatin, etc.

3. Serum Antidiphthericum. Antidiphtheric Serum,official. - (Syn., Ser. Antidiph., Diphtheria Antitoxin; Fr. Serum antidiphterique; Ger. Diphtherie-Heilserum.)

Manufacture: A fluid, having a potency of 250 antitoxic units per Ml. (Cc), separated from the coagulated blood of the horse, E'quvs cabal'lus, or other large domestic animal, which has been immunized properly against diphtheria toxin. It is a yellowish, yellowish-brown, transparent or slightly turbid liquid, with sometimes a slight granular deposit; nearly odorless, or odor of antiseptic employed as a preservative, gradually loses potency, in one year 10-30 p. c. Must come from healthy animals, be sterile, free from toxins or other bacterial products, not contain excess of preservative (.5 p. c. of phenol or cresol, when either used), and not more than 20 p. c. of total solids.

Commercial. - The diphtheria bacillus when developing in the body causes the formation of toxins, albumoses, an organic acid, and a substance called antitoxin, which is present in the blood. Frequently the inherent quantity of antitoxin is sufficient to antagonize thoroughly the toxin produced, thereby insuring life; on the other hand, additional antitoxin may have to be introduced in order to save the patient. A culture of diphtheria bacilli may be grown on meat broth in a flask, to which have been added .5 p. c. of sodium chloride and 2 p. c. of peptone. After several weeks the bacilli are filtered off, when the remaining fluid should contain considerable diphtheria toxin of sufficient strength that eiss (.1 Ml. (Cc.)) will kill a guinea-pig. Now of this eiij-15 (.2-1 Ml. (Cc.)) are injected into a vein of a healthy young horse, which produce only slight symptoms; these having disappeared, a larger dose is administered to be followed with diphtheritic disturbances, and increasing doses repeated until ℥iij (90 Ml (Cc.)) are given at each injection with little or no effect, thereby insuring a large amount of antitoxin in the blood serum. After several months 1 gallon (4 L.) of blood is withdrawn from the jugular vein of the horse into a sterilized vessel, allowed to coagulate, and the antitoxin serum placed in sterilized bottles, with some antiseptic (.5 p. c. phenol or cresol), and hermetically sealed. Can only be prepared in establishments licensed by the Secretary of the Treasury, United States, and each container must bear upon the label its name and number, also manufacturer's name, address, license number, date beyond which product is likely to be unreliable, and total number of antitoxic units claimed. Should be kept dark, in sealed glass containers, at 4.5-15° C. (40-59° F.), and not sold or dispensed when of lower potency than 250 units per Ml. (Cc.). Dose, hypodermic, 10,000 units; protective, 1,000 units.

Preparations. - 1. Serum Antidiphthericum Purificatum. Purified Antidiphtheric Serum. - (Syn., Ser. Antidiph. Purif., Antidiphtheric Globulins, Concentrated Diphtheria Antitoxin, Diphtheric Antitoxin Globulins, Refined and Concentrated Diphtheria Antitoxin, Solution of Antitoxic Globulins.)

Manufacture: Separate from the serum or plasma of the immunized animal the antitoxin bearing globulins (by adding ammonium sulphate), dissolve in water, add sodium chloride sufficient to make a .G-.9 p. c. solution of the salt. It is a transparent, slightly opalescent liquid, sometimes with slight granular or ropy deposit, or more or less viscous; nearly odorless, or odor of antiseptic employed as a preservative (.5 p. c. of phenol or cresol, when either used); total solids must not exceed 20 p. c., must have the potency of 250 units per Ml. (Cc); must conform to all requirements of antidiphtheric serum, and he kept with same precautions. Dose, hypodermic, 10,000 units; protective, 1,000 units.

2. Serum Antidiphthericum Siccum. Dried Antidiphtheric Serum. - (Syn., Ser. Antidiph. Sicc, Dried Diphtheria Antitoxin.)

Manufacture: Evaporate either of the preceding liquid serums in a vacuum, over sulphuric acid or other desiccating agent, or pass over it a current of warm air freed from bacteria, when it has the potency of 4,000 units per Gm. It is in orange-yellowish flakes, small lumps, yellowish-white powder; odorless, soluble in water (9), solution being opalescent and slightly viscous. For use - dissolve serum immediately beforehand in recently boiled and cooled distilled water - 9 (?) preferably in the original container, under most rigid aseptic conditions, when it has the potency of 250 antitoxic units per Ml. (Cc). Must conform to all requirements of antidiphtheric serum, be kept dark, in hermetically sealed, amber-colored glass containers free from air, at 4.5-15° C. (40-59° F.); does not lose in potency, as does the liquid serum. Dose, hypodermic, 10,000 units; protective, 1,000 units.

Properties and Uses. - Diphtheria and immunity therefrom. The serum should always be injected with a specially devised syringe, preferably between the shoulders or on the side of the abdomen, the skin having been washed with an antiseptic prior to the injection. It is advisable to use small doses of concentrated, rather than large doses of diluted serum, and within the first 24 hours the patient should receive 2,000-4,000 normal units, divided into two or three doses, and each day thereafter the same quantity until improvement is manifest. The earlier the treatment the more certain the cure; erythematous rash, painful and swollen joints, fluctuations in temperature, etc., may follow several weeks after its use; large doses are not poisonous, and produce least distention of the tissues.