APPLICATION OF THE PHENOMENON 42I 



are employed pooled strains of B. coli from patients affected with 

 severe ulcerative colitis. Possibly, concentrated sera may also give 

 better results (Shuartzman and W'inkelstein, 1 9.^54 ) . 



MOCCASIN VENOM IMMUNIZATION IN CERTAIN FORMS OF 

 HEMORRHAGIC DIATHESIS AND RECURRENT EPISTAXIS 



As described in Chapter vi, Peck and Sobotka (19^^!) showed 

 that when fourteen days to one month ^vere allowed to elapse 

 between the time of injection of rabbits ^vith snake \enom and 

 the elicitation of the phenomenon of local skin reactivity, a large 

 number of the animals became refractory to the latter. Since no 

 circulating antibodies coiUd be demonstrated to explain this non- 

 specific refractory state, and since anti-\enom had no effect on 

 the course of the phenomenon, the induced refractoriness was 

 thought by these authors to be due to some change in the vessel 

 walls which made them resistant to the active bacterial principles 

 and thus prevented the hemorrhage. W^ith this assumption in mind, 

 Peck (1932, 1933, 1934) and Peck and Goldberger (1933) treated 

 diseases which could be grouped under hemorrhagic diathesis 

 with snake venoin. Patients showing certain allergic phenomena 

 such as urticaria, neurodermitis, as Avell as asthma and hay fever, 

 were also treated. 



One group consisted of 3 cases of thrombocytopenic purpura, 

 one case of Schoenlein-Henoch's syndrome (Frank's capillary toxi- 

 cosis) , and 2 cases of hemophilia. The hemorrhagic purpura cases 

 had such symptoms as epistaxis and purpura; in 2 of them there 

 was a history of prolonged and profuse menstrual periods. Two 

 of this group have been under treatment ^vith snake venom for 

 nine months, and one for six months. The three patients shelved 

 definite clinical improvement ^vith a marked increase in purpura 

 and epistaxis, and a decrease in the duration and profuseness of 

 the menstrual Ho^v. In one patient the platelet count was now 

 220,000, ^vhile in the other two it was still below 60,000 when 

 tiie report was written. 



The patient Avith Schoenlein-Henoch's syndrome had recinrent 

 purpura, hematuria and a history of prolonged and profuse men- 

 strual periods. The menstrual period wiiich came on after she 

 had received treatment Avith snake venom for several weeks ^vas 

 shorter and markedly less profuse. Her hematuria has disappeared 

 and she has been free from purpuric manifestations for over a 

 month. 



