WILLIAM H. PARK 939 



serum, and plasma obtained from measles convalescents.' Degwitz, in 1920, 1921, 

 and 1922, published the results obtained by him and those working with him in more 

 than one thousand cases. The results were on the whole quite favorable in that if the 

 disease was not prevented in some, it was lessened in its severity. His routine method 

 was to draw the blood between the seventh and seventeenth day after convalescence, 

 allow it to clot, and use the serum intramuscularly after sterility and Wassermann 

 tests had been done. Degwitz does not believe that the results obtained warrant the 

 use of serum after the seventh day of exposure. He reports among his own series 85 

 per cent complete protection. This is more favorable than the results in other large 

 series. Probably some of his children were not very markedly exposed. 



Since 192 1 the convalescent serum has been utilized with excellent results in the 

 hospitals for contagious diseases in New York City in children who have been ex- 

 posed by the development of measles in the wards. A grant of money by the Metro- 

 politan Life Insurance Company made it possible to attempt to provide enough serum 

 for all exposed inmates in children's institutions in New York City, and also for all the 

 children in the city who were under three. These classes of children were chosen be- 



TABLE II 



Amounts of Serum Used by Degwitz 

 2.5 CO. in those exposed 4 days or less 

 5.0 CO. in those exposed 6 days or less 

 7.0 CO. in those exposed 7 days or less 



cause institutional children and those under three years of age are the most liable to 

 pneumonia. 



The use of convalescent serum in an infected child may prevent the development 

 of the disease, modify the severity of the attack, or fail entirely of any effect. So far 

 as the interests of the child are concerned, the best result is the development of a very 

 mild attack. Under such conditions there is practically no danger of complicating 

 pneumonia or of any other complication. Recovery is practically certain, and the child 

 has the advantage of an active immunity which may be considered lifelong. Those 

 children have as a rule a very slight rise of temperature, perhaps to 100° or 101° for a 

 day or so, and a slight coryza, and a very slight to a moderate rash. Koplik spots may 

 or may not be present. Those who are absolutely protected have only a passive im- 

 munity so long as sufficient serum remains, and this varies from about two to four 

 weeks, and depends on the individual and the amount of serum injected. The child 

 is after this period as susceptible as before. 



The great problem in the prevention of measles by this method has been the diffi- 

 culty of obtaining a continuous supply of blood large enough to meet the demands. 

 When we realized the value of the serum in New York, as far as possible, every adult 

 measles convalescent was asked to give some blood, for which service a suitable re- 

 ward was offered. Because of the small incidence of measles in adults in New York 



'A bibliography is given by Zingher, A.: "Convalescent Whole Blood, Plasma, and Serum in 

 Measles," J. A. M. A., 82, 1180-87. April 12, 1924. 



