942 HUMAN SERUM FROM CONVALESCENT CASES 



only two developed paralysis and none died, while those treated after paralysis had 

 developed had a high mortality. Zingher believed the serum was very beneficial 

 in the early cases and of doubtful value in those in whom paralysis had developed. 

 Neal, with even more experience with cases treated by intraspinal injections, was 

 very doubtful as to its value. Personally I do not believe in the streptococcic origin 

 of the disease or in the antistreptococcic serum. As we have no reliable potent anti- 

 virus serum from horses, I should be inclined to use the convalescent serum. I think 

 it should be given both intraspinally and intravenously. 



USE OF SERUM FROM CASES OF CONVALESCENT INFLUENZA IN 

 INFLUENZA PNEUMONIA 



The fact that an attack of influenza develops in the patient an immunity to the 

 disease, and probably also an immunity to complicating infections suggested the 

 use of the blood or serum of convalescent cases in the treatment of severe and 

 complicated cases. Ross and Hund' treated a group of cases with transfusion or in- 

 travenous injections of 250-500 cc. of citrated blood taken from compatible donors 

 among convalescent cases of influenza; the mortality rate was 21.4 as against 42.8 

 per cent among cases treated symptomatically. It seems to the writer that the re- 

 sults published indicate that the serum from convalescent cases or from immunes 

 who did not contract the disease when exposed is of value. In influenza pneumonia 

 we are treating the complicating infections more than that caused by the influenza 

 virus. 



USE OF CONVALESCENT SERUM IN LETHARGIC ENCEPHALITIS 



This is still wholly experimental; as we do not know the germ we have no way 

 of testing its potency. Neustaedter, Larkin, and Banzhaf^ report that monkeys were 

 protected against poliomyelitis by the administration of sera from human conva- 

 lescent cases of encephalitis. If these antibodies were developed against the virus 

 of poliomyelitis, it would seem certain that they were developed against the 

 virus of epidemic encephalitis, but Amoss^ found that in his test monkeys the 

 sera of recently recovered human cases of encephalitis were unable to neutralize the 

 virus of poliomyelitis and regards the two diseases as two entirely separate entities. 



The probabflity is that a considerable percentage of healthy human beings 

 have antibodies against the poliomyelitis virus and that they were not developed 

 because of the encephalitis. 



Gruenwald^ has injected 80-100. cc. of convalescent serum intragluteally in the 

 treatment of the disease, possibly with some success. If sufficient serum is avail- 

 able it would appear advisable to administer it intraspinally and intravenously in the 

 same manner as described for the treatment of poliomyelitis. 



' Ross, C. W., and Hund, E. J.: J. A.M. A., 72, 640. 1919. 



= Neustaedter, M., Larkin, J. H., and Banzhaf, E. J.: Am. J. M. Sc, 162, 715. 1921. 



3 Amoss, H. L.: /. Exper. Med., 33, 187. 1921. 



■f Gruenwald, E. A.: Deutsche med. Wchnschr., 46, 1243. 1920. 



