94 VACCINE AND SERUM THERAPY. 



of administration of specific immune sera. While anaphylactine 

 has not been found in the blood serum of man, later investigation 

 may show that the phenomenon of serum disease in man corresponds 

 to sudden death and anaphylaxis in guinea pigs. 



The markedly beneficial results of injections of specific im- 

 mune sera in the prevention and cure of certain diseases, have 

 so far outweighed the undesirable and serious results which have 

 followed serum therapy, that most physicians have given little 

 attention to the contra-indications of serum injection. As the 

 indications and contra-indications for injection of immune serum 

 are better understood by physicians fewer objections to serum 

 therapy, scientifically applied, will be made. That serious ob- 

 jections to the injection of immune sera have some foundation, 

 is evidenced by the fact that Rosenau and Anderson have been 

 able to collect a considerable number of cases of sudden deaths 

 in man after the injection of immune serum. It has been noticed 

 from the first that in the cases of sudden death following the in- 

 jection of diphtheria anti-toxin there is marked respiratory em- 

 barrassment. Rosenau and Anderson believe the essential lesion 

 of serum anaphylaxis is localized in the respiratory centers. 

 In collecting statistics on this subject these investigators have 

 found two cases, "and also others have come to our notice," in 

 which sudden death followed the injection of anti-toxin into 

 asthmatics. From these observations Rosenau and Anderson 

 conclude that "the knowledge of the fact that injection of horse 

 serum into asthmatics may be attended with danger, should be 

 considered in the use of anti-toxins." 



While there are some cases in which the injection of horse 

 serum has been followed by sudden death due to a hypersuscepti- 

 bility to horse serum, most of the deaths have undoubtedly been 

 due to other causes. Frequently physicians and laymen wrongly 

 attribute undesirable conditions to the use of diphtheria anti- 

 toxin and other immune sera. In the use of some immune sera, 

 especially diphtheria anti-toxin, recovery from the disease is so 

 rapid and early, that the physician and patient overestimate the 

 physical condition of the patient, and as a result the patient is 

 frequently allowed a certain amount of exercise. This at times is 

 followed by unfavorable symptoms. The condition in these cases is 

 probably due to the action of diphtheria toxin rather than 



