WILLIAM H. PARK 



941 



CONVALESCENT SERA IN THE TREATMENT OF EPIDEMIC POLIOMYELITIS 



Following the discovery by Flexner and Lewis' and by Levaditi and Landsteiner^ 

 that the serum of monkeys convalescent from an attack of poliomyelitis contained 

 antibodies which were capable of neutralizing the filterable virus, it was found that 

 the serum of human convalescents was equally efficacious. The serum from slight 

 abortive cases is on the average as potent as that from pronounced cases. The serum 

 of many persons who have never had poliomyelitis contains antibodies, but these are 

 not so potent as in the serum of convalescent cases. The antibodies remain in the 

 blood of convalescents for a long time. 



Netter-' utilized this information to test the value of the serum therapeutically in 

 human cases. The serum should be free from hemoglobin as this causes irritation 

 when the serum is injected intraspinally. At first it was given only intraspinally 

 but, owing to the fact that the disease affects the tissues of the brain and cord rather 



TABLE III 

 Institutional Children Receiving Preventive Injections Against Measles. 



than the covering membranes, and also to the discovery by Flexner and Amoss'' that 

 the aseptic meningitis set up by the intraspinal injection promotes the passage of anti- 

 bodies from the blood to the cerebrospinal fluid, the serum is now usually given both 

 intraspinally and intravenously. On the first treatment injections are given both 

 intraspinally and intravenously and later injections for one to three days intraspinally. 



Amoss and Chesney^ state that the following conditions should be observed: (i) 

 early and prompt diagnosis and treatment, (2) intraspinal injection of immune serum, 

 (3) intravenous or intramuscular injection, (4) the serum injected should have been 

 collected from cases which have recently passed an attack of poliomyelitis. The serum 

 is preserved by the addition of 0.2 per cent tricresol. In children they advise that 10-20 

 cc. be given intraspinally and 40-80 cc. intravenously. If given before the develop- 

 ment of paralysis, these injections may be sufficient; if not, the intraspinal injection 

 may be repeated. 



In the 1 91 6 epidemic in New York Neal and Zingher treated a large num- 

 ber of cases of poliomyelitis. In those seen early before paralysis had developed the 

 results were very good whether serum was used or not. Thus in twenty-five early 

 cases treated by Zingher at the Willard Parker Hospital with intraspinal injections, 



' Flexner, S., and Lewis, P. A.: ibid., 54, 45. 1910. 



* Levaditi and Landsteiner, K.: Compt. rend. Soc. de bioL, 68, 311. 1910. 



sNetter, A., et al.: ibid., 70, 625, 707, 739. 191 1. 



■f Flexner, S., and Amoss, H.: /. Exper. Med., 19, 411; 20, 249. 1914. 



s Amoss, H., and Chesney, A. M.: ibid., 25, 581. 1917. 



