266 THE PRINCIPLES OF IMMUNOLOGY 



type, including slight fever, pain in the legs, but in rare instances violent 

 symptoms have been observed. Before and after the treatment a Was- 

 permann test, the globulin test and a cell count should be made. After 

 one week or more the treatment can be safely repeated until definite 

 improvement occurs. 



TREATMENT WITH IMMUNE HUMAN SERUM 



Weisbecker in 1897 appeared to be the first to have used blood 

 serum of convalescents, in cases of scarlet fever, but with little success. 

 Huber and Blumenthal, von Leyden and others renewed the interest 

 in convalescent serum therapy but failed to reach any definite con- 

 clusion probably because of the small doses employed. Reiss and 

 Jungmann, Koch, Zingher and Weaver more recently applied the 

 treatment with a fair degree of success. Reiss and Jungmann gave 

 intravenous injections of 40 c.c. to 100 c.c. and drew the blood from 

 scarlet-fever convalescents about the end of the third or beginning of the 

 fourth week of the disease, testing each serum for the possibility of 

 syphilis and for sterility. Zingher injected citrated whole blood intra- 

 muscularly in doses of 120 c.c. to 240 c.c. and repeated in two or three 

 days if necessary. Weaver drew the blood from convalescents between 

 the twentieth to twenty-eighth day, only such convalescents being selected 

 who had not been septic and who gave a negative Wassermann reaction. 

 The sera were tested for sterility and used pooled. Intramuscular in- 

 jections were given in doses of 25 c.c. to 90 c.c., 60 c.c. being the usual 

 amount. The effects of the serum are rapid and start with a sudden drop 

 in temperature and general improvement of the patient within twenty- 

 four hours after the administration of the serum. The best results 

 are obtained when the patients are treated early in the disease. Kling 

 and Widfeldt also reported favorable results in their series of cases 

 during an epidemic of 237 cases at Stockholm in 1918. This method has 

 not been widely adopted and there is still much question as to whether 

 improvement is due to the treatment or to the natural self -limitation 

 of the disease. 



Monvoisin has recently reported encouraging results in typhus fever 

 by intravenous injections of human convalescent serum. One or two 

 cubic centimetres of serum brought a marked drop in temperature and 

 general improvement in the patient. Monvoisin noted a decrease in 

 mortality from 30 down to 10.34 per cent, by the use of convalescent 

 sera. The serum was obtained from a patient on the eighth day after 

 subsidence of fever. Favorable results were also reported by Teissier 

 in cases of severe and hemorrhagic smallpox. In leprosy the serum 

 obtained from cantharides blisters on lepers has been reported to 

 be of value. 



Bleyer recently injected immune human blood into a series of forty- 

 five cases of whooping-cough in the early weeks of the disease. This 

 series was divided into three groups. The first group received blood 

 from persons who were convalescent or who had recovered from 

 whooping-cough within three months. In the second series the blood 



