PAPERS OX MEDICINE AND PUBLIC HEALTH 



to in order to desensitize. This procedure in man • 

 not, unfortunately, give the same uniform resull 

 noted in experimental animals. It may be said, however, 

 that divided doses, although they may fail to give tl: 

 action, or repeated small doses may induce 

 but this is not considered proof that we are inducing the 

 mechanism of desensitization so uniformly d in 



experimental animals. 



(2) Priuention of Serum Eeactio)is. — Persons who 

 give a suspicious history should be tested cutaneously 

 for evidences of hypersensitiveness. The appearance of 

 a wheal at the site of injection indicates that the person 

 so tested will show a fairly immediate serum reaction, 

 such as rise of temperature or urticarial rash,, but is no 

 indication of the probable severity of the same. The 

 absence of such a skin reaction indicates, but does not 

 prove, that there will be no undesired results following 

 the administration of the serum. The procedure usually 

 followed and recommended is to inject the antitoxin or 

 other serum in divided doses every 20 to 30 minutes, 

 starting with 0.1 c.c, until symptoms are observed or 

 until sufficient is given. If symptoms develop one can 

 then attempt repetition of smaller doses which previous- 

 ly did not cause symptoms. Where serum is to be ad- 

 ministered intravenously, dilution and exceedingly slow 

 administration in the beginning will tend greatly to pre- 

 vent undesirable results. Intraspinous injections should 

 be given slowly, especially the initial portion follow- 

 ing a recent previous injection. Hypodermic injection 

 of atropin or epinephrin will usually relieve the less 

 severe attack- of serum shock. In cases of extreme col- 

 ■. artificial respiration should be resorted to. 



All fray to Foods, Pollens, Etc. — After the ingestion of 

 specific foods, rashes and other forms of reaction occur 

 in a small percentage of individuals. These may follow 

 the eating of eggs, certain kinds of meat, including fish, 

 fruits, etc. A- stated above, the inducing sul 

 may or may not be antigenic in character. Hay fever is 

 an example of mucous membrane hypersensitive- 

 Persons suffering from this condition may also show 

 skin sensitiveness and even develop i: r other 



