A. Vaccines.

1. Cultivations.

a. Containing pathogenic micro-organisms; such as anthrax, one form of cancer vaccine, cholera vaccine, Coley's fluid, Haffkine's plague vaccine, tuberculin and T. R. of Koch, typhoid vaccine of Wright.

b. Containing toxins only; such as one form of cancer remedy, diphtheria toxin, mallein, tetanus toxin, and tuberculin Koch (?).

2. a. Tissues of animals suffering from an infectious disease; such as malignant oedema and rabies. b. Fluids of animals suffering from an infective disease; such as vaccine lymph, and glycerinated calf lymph.

B. Anti- Serums - Anti iphtheritic and Antitetanic

Serums. I. Antitoxins; such as antipneumonia, antivenene, and diphtheria and tetanus antitoxins.

2. Antibacterial; such as cancer antibacterial serum, cholera antibacterial serum, antileprosy serum, antitubercular serum, antirabic serum, antistreptococcic serum, antityphoid serum, and Yersin's plague serum. C- Animal Tissue Extracts - Organo-Therapy. Bone marrow, thyroid extract, and suprarenal extract are the chief of these. (Sims Woodhead's Classification.)

Diphtheria antitoxin is prepared as follows: A colony of diphtheria bacilli, after being placed in a suitable medium and under favorable conditions, multiply with great rapidity, secreting at the same time their poison or toxins. After a few weeks, when sufficient of the toxin has formed, the bacilli are destroyed by means of carbolic acid, and by filtering through porous plates of clay the dead bacilli are removed from the solution of toxins. Of this solution small amounts are injected into the blood of a healthy horse, producing a mild attack of the disease; this procedure is then repeated for several months, the doses of toxin being steadily increased until the animal becomes habituated to the poison. Then a quantity of blood is withdrawn from the animal, and the serum, or aqueous portion, is separated from the red blood corpuscles, this serum constituting a light yellow liquid which contains the antitoxin of diphtheria. The serum is standardized by determining the quantity required for injection to neutralize a fatal dose of diphtheritic poison in a guinea-pig; the ratio between the quantity of antitoxin and the body weight of the animal furnishes a means of indicating in definite units the strength of the solution.

Behring's

No. 1 equals 600 immunizing units; No. 2, 1000; No. 3, 1500. In 1/2 oz. vials, varying measure but full unit value.

Gibier's (N. Y. Pasteur Institute). - Identical with Roux's. Immunizing power, 1:100,000 - i. e., 1/2 mil, prophylactic up to 110 pounds; regular treatment, 5-15 mils a day.

Roux's

Same description as Gibier's.

Schering-Aronson

Supplied in vials containing 5 mils, equivalent to 500 antitoxic normal units.

Every case of diphtheria should be treated with the antitoxin as early as possible, 3000 units being an average first dose. All persons exposed should be given an immunizing dose of 500 units, except children under two years, with whom 300 units is sufficient, repeating the dose every three weeks in any case, until all danger is past. The antitoxin is used as directed under "Hypodermics."

Vaccine Virus

This comes in small sealed glass tubes in sterile form and is the official lymph for vaccination. Only such vaccine virus may be sold as has been made in places licensed by the Secretary of the Treasury of the U. S. The tubes may be large or small and will vaccinate from 2 to 80 persons, depending upon the size of the tube used.

Antivenene (serum antiveneneux, Calmette) is prepared from the blood of asses and horses which have been immunized against snake poison. The power of immunization is 1 in 10,000. It should be carried by all persons going to a district infested with snakes, especially in India. The dose for adults is 20 mils; for children, 10 mils; in very dangerous cases the dose is doubled.

Antistreptococcus and Antipneumococcus sera have not proved to be distinctly valuable, although the former may do good, and can do no harm in general infections, erysipelas, and scarlet-fever. Large and frequent doses are required.

Many other sera have been exploited, among them anticholera, antidysentery, antiscarlatina, and those for the cure of yellow fever, anthrax, glanders, leprosy, whooping-cough, erysipelas, syphilis, malaria, and hay-fever, but none of these has yet proved of marked practical value.

Red Bone Marrow Extract

The marrow of ox-bone and sheep-ribs has been used as a remedy for chronic debilitating blood diseases. It comes in the form of tablets containing one grain of the desiccated marrow, equal to twenty grains of the substance in its natural state. Each tablet weighs three grains. Dose, 1-3 tablets.

Dried Suprarenals

This is now an official product, as given on page 268.

The active principle of the gland, epinephrin, has been isolated by Abel and Crawford, but it is not used in therapeutics. The dried extracts of the whole gland, or a liquid extract, or adrenalin may be used. These preparations are notable for causing contraction of small blood-vessels when applied locally, blanching the skin or mucous membrane, and for a general tonic effect on the heart and arteries when given internally.

They strengthen the heart's action and slow and regulate the pulse, causing a rapid rise in blood pressure.

Adrenalin Chloride Solution. Not official.

Average dose,  xv.-i mil by the mouth. Diluted with normal salt solution ten times it is used as a hypodermic injection, and has been suggested for intravenous injection. It is injected with cocaine and eucaine to cause anaesthesia and bloodless operations. For spray inhalations the strength of 1 to 2500 or 1 to 5000 is effective. The solution is easily oxidizable and should be kept closely stoppered and away from the light.