APPLICATION OF THE PHENOMENON 413 



Blood cultures were repeatedly negative. Although all other clinical mani- 

 festations of typhoid fever disappeared, a postinfectious psychosis persisted 

 in spite of normal temperature for three weeks after the end of the disease. 



MOMTH JULY AUG. 



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 DAYS OF DISEASE 



Fig. 44. Temperature Clhai t II. Case B. R. 



43 H5 



Case B. R. This patient was admitted to the hospital on the third day of 

 the disease. She was moderately toxic and the temperature reached 104.6 to 

 105° daily. A total of 200 c.c. of the anti-typhoid serum was administered 

 on the sixth to seventh days of the disease. On the eighth day she appeared 

 less drowsy; on the ninth clay the temperature began to drop and became 

 normal on the eleventh day of the disease. Six days after the injection of 

 the serum, the patient developed sertmi sickness, i.e., fever, urticaria and 

 polyarthritis which persisted for three days. The agglutination titers (Widal 

 tests) which were negative before the serum injection were 1:1280 on the 

 eighth, ninth and twelfth days of the disease, dropped to 1:320 on the 

 thirty-third day of the disease and subsequently became negative again. 



Case C. B. This patient Avas admitted on the ninth day of his illness. He 

 was acutely ill, typhoidal and moderately toxic. Temperature ranged between 

 100.4 to 106° during the three clays before serum administration. A total of 

 485 c.c. of antityphoid serum was injected intravenously during fifteen and 

 one-half hours. Within twenty-four hours following the injection of the serum, 

 the temperature dropped to normal (i.e., twelfth day of the disease) and 

 remained normal thereafter, with the exception of a peak-like rise to 101.8° 

 F. for the afternoon of the eighth day after the last serum injection. The 

 rise was coincident wtih serum sickness, which manifested itself in urticaria 

 and pruritus. 



Twenty-four hours after the serum iniection, i.e., on the tenth dav of ill- 

 ness, the AVidal test ^vhich had previouslv been negative, reached a titer of 

 1:320. 



