412 LOCAL TLSSUE REACTIVITY 



dm at ion ol lexer in an) i;i\cn case presents man) diliu nkies. 

 The liistoi) was olten \at^ue as to the date ol onset; the (linical 

 j)i(tme was Ire(jnentl) obscnied by temj)eialme (hie to (()m|)li(a- 



MONTH JULY 



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Fig. 43. Tenipeiatiiie Clhart I. Case G. \V. 



tions, intercurrent intections or serum sickness. Fifty-six of the 

 serum treated cases had a temperatiue duration of over thirty 

 days. In 22 cases the diuation was less than thirty days. 



Teinperatine effect. T^venty-five cases had a mean temperature 

 fall folloxving serinn. Some of these followed the seriun so 

 promptly and occmred so early in the disease, that it was felt 

 that the serum played the important part. In some cases it oc- 

 cmred at the time when defervescence normally begins and the 

 part played by the serum is discoiuited. 



The following histories of 3 of the cases illustrate the sudden 

 and dramatic change in the disease in these cases and a totally 

 unexpected end of the disease ^vithin a fcAV days. 



Case G. W. This patient seemed to be dying. He was extremely toxic, 

 constantly delirious, disoriented, and involiuitary. The blood cidtme was 

 positive for B. typhosus, the spleen was palpable and there xvas a pronounced 

 leucopenia; 102 c.c. of the serum was given on the eighth to tenth days of 

 the disease. The most dramatic effect was tipon the fever. The temperatiue 

 reached normal and the disease apparently terminated on the ele\enth day. 



