APPLICATION OF THE PHENOMENON 415 



As is seen from Temperature Chart IV, there was an immediate rise in tem- 

 perature up to 104.8° F. following injection of the serum. The temperature 

 remained approximately at this level for the next twenty-four hours, and 



Fig. 46. Temperature C'.liarl I\'. Normal X'ohinteer. 



sharply dropped to normal within the second t\venty-fotu- horns. On the fifth 

 clay after injection of serum, typical manifestations of serum sickness with 

 fever fluctuating between 99-101.8° f. persisted for several days until the tem- 

 perature again became normal. The occurrence of similar fevers of serum 

 sickness following the injection of antitoxic anti-typhoid serum into typhoid 

 patients, may have served to prolong the temperature ele\ation and to ob- 

 scure an otherwise obvious influence of the serum upon the toxic manifesta- 

 tions of the illness and tipon the duration of the disease. 



Fourteen cases had no bad effects of any sort; thirty-nine had 

 mild sertmi sickness; t^venty-tAvo liad severe serum sickness; i.e., 

 sharp rise in temperature, urticaria, arthralgia, etc. Three cases 

 had an anaphylactic shock. Four cases had t^vo bouts of serimi 

 sickness and one case had foin. 



Effect of serum on agglutitii)i.s for B. tyl)hosus. In 47 cases 

 Widal titrations were made shortly before the sertim administra- 

 tion, one to three days after the injections ^vere completed and 

 frequently at short intervals of time initil the patient was dis- 

 charged. 



The analysis of data obtained is as follo^vs; 



Twenty-two cases showed a marked rise in the aggkitination 

 titer unquestionably due to the injection of seriun. In 18 of these 

 cases the Widal titer recorded previously as negative or in the 

 range between 1:80 to 1:160 reached a titer of 1:1280 within 



