340 APPLIED IMMUNOLOGY 



administered intravenously, to reach the spinal fluid in any 

 considerable quantity. In any event, so far as the effective 

 treatment of cerebrospinal lues, especially paresis and 

 notably tabes dorsalis, is concerned, it prompted a number of 

 investigators to apply both salvarsan and neosalvarsan di- 

 rectly to the subarachnoid spaces by spinal puncture. 

 Wechselmann,^ Marinesco,^ Marie and Levaditi ^ were prob- 

 ably the first to employ this method. The practice was 

 attended frequently with such marked reactions, and even 

 fatalities, that it has already become obsolete. The modi- 

 fications as suggested by Ravaut" and Wile ^ using hyper- 

 tonic solutions of neosalvarsan are likewise not beyond re- 

 proach and must be regarded as dangerous procedures, not 

 to be recommended for the average case. 



Autosalvarsanized Serum, — Swift and Ellis ^ have per- 

 fected and recommended the intraspinal injection of the 

 patient's own salvarsanized serum, irrespective of the fact 

 that it is impossible by the Marsh test to demonstrate the 

 presence of arsenic in the serum of patients shortly after the 

 intravenous injection of an adult dose of salvarsan, where- 

 fore if present it must be in minute quantity, rendering the 

 modus operandi of the apparently beneficial effect of this 

 method of treatment difficult of comprehension. Possibly the 

 antibodies in the serum itself may be a most important 

 factor. It is unquestionably true that autosalvarsanized 

 serum is much less irritating and dangerous than direct sub- 

 dural injections of salvarsan or even hypertonic solutions 

 of neosalvarsan. Consequently, this method is deservedly 



*Deutsch. med. Wochenschr., 1912, 38, 1446. 



= Zeitschr. fiir Phys. und Therap., 1913, 17, 194. 



« Bull, et Soc. med. d. hop., Paris, November 18, 1913. 



^ Ann. de Med., 1914, 1, 49. 



"Jour. Am. Med. Assn., 1914, Ixii, 1165; ibid., 1914, Ixiii, 13T. 



» New York Med. Jour., July 13, 1912, 53. 



