940 HUMAN SERUM FROM CONVALESCENT CASES 



City and the usual refusal of patients to give their blood, this source of supply proved 

 to be inadequate. It then came to the attention of the department that there was 

 an epidemic of measles of considerable extent among the young adult students of a 

 southern university, all of whom came from rural districts. The students volunteered 

 in large numbers to give their blood, and as they had all been treated in the university 

 hospital, the diagnosis of measles was certain. It is in some such way as this that a 

 supply must be obtained. 



The method of drawing the blood was as follows: At the Willard Parker Hospital, 

 blood was drawn on the ninth day after the defervescence of fever up to the twenty- 

 first day, but at the southern university the time was more varied, and some was 

 drawn as late as five months after the disease. In the case of adults, all the blood was 

 drawn through a i6-gauge Luer needle into a 500-cc. bottle containing 20 cc. of 25 

 per cent sodium citrate solution and 0.3 gm. of oxyquinolin sulphate (chinosol) as a 

 preservative. This preparation was used because it was found that in the dilution in 

 which it was used it was an efficient bactericidal agent; the red cells were not de- 

 stroyed, and it was not irritating when injected intramuscularly. The bottles were 

 then put in the icebox and the cells allowed to settle, or were centrifugated, and the 

 plasma pipetted off. Blood for a Wassermann test was taken at the time of bleeding, 

 and a steriUty test was done at the time the plasma was put up into small bottles. 



Plasma was used instead of serum, because of the greater yield for the amount of 

 blood drawn and the greater ease of handling. All the blood drawn within six days 

 of the same period in convalescence was pooled. Thus far, the figures indicate that 

 the efficiency of the plasma is not markedly diminished by postponing bleedings for 

 three months after the occurrence of the disease, and that storage in the icebox for 

 six months does not appreciably alter its usefulness. The plasma was put up in 3-cc. 

 and 6-cc. vials and 30-cc. bottles. The vials were distributed to private physicians 

 with printed directions for use, and a card was given which was filled out by the 

 physician and mailed back to the laboratory. This card contains questions concern- 

 ing the number of children exposed, the date and type of exposure, the date of injec- 

 tion,, and the lot number of plasma. Twenty-one days after injection, each case was 

 investigated by a member of the department staff. The 30-cc. bottles were kept for 

 institutional use when a large number of children were to be injected. 



RESULTS OBTAINED IN NEW YORK CITV^ 



More than 1,500 children received preventive injections between December i and 

 June I, 1925. From 979 we have fairly accurate data as to the date and degree of 

 exposure, the amount of plasma injected, and the success attained. Of these 979 

 children, 753 were exposed in institutions and 226 in private families. In 404 of the 

 institutional children and in all of the children in families, the exposure was direct. 

 In 349 it was indirect in that actual personal contact with a measles patient was 

 not proved. 



No bad effect followed the injections in any case. Only one of the children died 

 and this one had an empyema before contracting modified measles and was only two 

 years of age. We do not think that the attack of measles appreciably hastened its 

 death. 



'■ Park, W. H., and Freeman, Jr., R. J.: ibid., 87, 556. Aug. 21, 1926. 



