AUTOSERUM THERAPY 265 



results from the injection of small doses (1 to 2 c.c.) of serum in 

 gonorrheal arthritis, and so on. 



A few years ago Hodenpyle met with an instance of carcinoma- 

 tosis associated with chylous ascites in which the disease seemed 

 to have been arrested, and in which he assumed that protective 

 antibodies (cytotoxins) were present in the circulation. He used 

 this fluid in large quantities in a number of cases of cancer, and for 

 a time apparently with a beneficial effect. The results, however, 

 were not lasting, and so far as my knowledge goes none of the treated 

 patients are now living. The donor, moreover, died within a year 

 of the time the treatment of the patients was begun. Following 

 these experiments a number of investigators used the ascitic fluid 

 of cancer cases in the treatment of the corresponding patients, but 

 likewise without any lasting benefit. 



Autoserum Therapy in Syphilis of the Central Nervous System. 

 Of late the patient's own serum has been advocated in the treat- 

 ment of syphilitic diseases of the central nervous system, the serum 

 being administered by the subdural route, and obtained from the 

 patient one hour after an intravenous injection of salvarsan. The 

 underlying idea is to bring both the salvarsan and any antibodies 

 that may be formed in the patient's own body into as intimate a 

 contact as possible, with the spirochetes, located in the perivascular 

 lymph spaces and the adventitia of the bloodvessels. This plan 

 seems thoroughly logical and deserves extended investigation. 

 That protective antibodies are actually present in the blood-serum 

 of treated syphilitic patients has been demonstrated beyond a 

 reasonable doubt. It has thus been observed by Taege that the 

 milk of syphilitic mothers, after treatment with salvarsan, develops 

 curative properties for the infected infants, and other investigators 

 have noted marked improvement in adults following the injection 

 of the serum of treated syphilitic individuals. The effects, however 

 were not lasting, and it hence appears rational to combine the use 

 of the salvarsan with that of the serum. The salvarsan, moreover, 

 when given by itself, by the subdural route, is too irritating to 

 warrant its use in this manner, while in combination with serum 

 this objectionable effect apparently falls away. 



Technique. The procedure which has been advocated by Swift 

 and Ellis is the following: One hour after an injection of salvarsan 

 or neosalvarsan, 50 c.c. of blood are withdrawn from one of the 



