APPLICATION OF THE PHENOMENON 419 



logical conditions and also several strains of rough B. coli vari- 

 ants. After a period of sexeral months, sera ^vere produced ^vhich 

 Avere capable of neutralizing B. coli reacting factors in mul- 

 tiple proportions. The titration of neutralizing potency was made 

 similarly to the titration of the anti-typhoid serum with the ex- 

 ception that the neutraHzing potency of 0.5 c.c. instead of 0.25 

 c.c. was determined. 



Clinical observations with phenomenon-neutralizing anti-coli 

 sera : 



The serinn employed for the treatment of 2 1 patients with non- 

 specific idcerative colitis contained from 25 to 75 phenomenon- 

 neutralizing units, from 800 to 1600 agglutinating and from 8 to 

 16 precipitating units. The clinical studies carried out in colla- 

 boration Avith Dr. Asher Winkelstein ^vere done as follows s: 



FolloAving a control period of tuo ^veeks, dining ^vhich eme- 

 tine and symptomatic therapy were given, conjunctival and intra- 

 dermal sensitivity tests ^vere performed. If negative, 0.5 c.c, 2 c.c, 

 and 5 c.c, were administered intramuscularly at six hour inter- 

 vals during the first day. If these injections were not followed by 

 severe reactions (chills, fever, urticaria) , intravenous medication 

 was given during the next forty-eight hours. It seems important 

 to give large quantities of the serum in a short space of time, 

 otherwise the antitoxin leaves the blood stream quickly. How- 

 ever, because of tlie possibility of dangerous shock, despite nega- 

 tive sensitivity tests, the following precautions -were observe"d: 



(1) Adrenalin solution was administered even for slight reactions; 



(2) divided dosage was employed — from 25 c.c. to 100 c.c. 



until 300 c.c. were given; (3) when the dose exceeded 25 c.c, 

 the drip method consuming at least one hom- uas used. In this 

 group, chills and moderate rises in temperature ^vere encountered 

 only t^dce. Urticaria (mild to severe) was the rule in from two 

 to nineteen days after completion of the serum therapy. In 3 cases 



(2 children and one adult) , the serum was administered intra- 

 muscularly. 



Material. During one year, 21 cases of non-specific colitis have 

 been treated. Sixteen were septic cases. All had long standing 

 severe colitis, associated \vith badly ulcerated mucous membrane'^ 

 and bloody, purulent diarrhea. Bacillary dysentery was excluded 

 bacteriologically and serologically. Amebae were not encountered 



