NORMAL SERUM THERAPY 773 



eration by performing cystostomy, removing clots, and filling the bladder 

 with sterile horse serum. 



This form of treatment is so simple and has been so successful in check- 

 ing hemorrhage in melena neonatorum and in other hemophilias following 

 injuries or operations that it should never be omitted. 



Defibrinated human blood, human serum, or the serum of the horse 

 and rabbit may be employed. The doses advised have been from 10 to 

 20 c.c. for infants and children and from 20 to 50 c.c. for adults. 



The technic is very simple. Sterile normal horse serum ready for 

 injection may be purchased in the open market. Human serum may be 

 secured by withdrawing blood into large centrifuge tubes (see p. 33) 

 and allowing the serum to separate, or the clot may be broken up after 

 an hour and the serum secured by rapid centrifugalization. For in- 

 travenous medication the serum should be free from particles of fibrin. 

 Indeed, the whole operation may be conducted at the bedside by with- 

 drawing blood from the donor into a flask containing sterile glass beads, 

 and after a few minutes of vigorous shaking the defibrinated blood is 

 injected subcutaneously or intramuscularly. Whenever human serum or 

 blood is used and time permits, a Wassermann reaction should be per- 

 formed beforehand, and it should be determined, by hemolytic and 

 agglutination tests, that the donor's serum does not hemolyze or agglu- 

 tinate the recipient's erythrocytes. (See p. 290.) Of course, all pro- 

 cedures should be conducted in an aseptic manner. 



NORMAL SERUM IN THE TREATMENT OF THE TOXICOSES OF PREGNANCY 

 Feiux, Freund, Rongy, and others have found injections of fresh 

 normal human serum from pregnant women, serum from placental 

 blood, and even horse serum useful in the treatment of the vomiting of 

 pregnancy. Freund has likewise observed that injections of Ringer's 

 and Locke's solutions are sometimes efficacious; he has found injections 

 of serum of some value in eclampsia, and tentatively advises its use in 

 this condition. The same observer has employed injections of normal 

 serum for the relief of the itching of pregnancy, and reports success. 

 Similar observations have been made by Veiel 1 and Wolf, 2 especially 

 after injections of serum secured from other healthy pregnant or recently 

 delivered women. 



To obtain placental serum, the following technic may be employed: 

 After the delivery of the child the cord is sponged with bichlorid solu- 



1 Munch, med. Wochenschr., 1912, lix, No. 35. 



2 Berl. klin. Wochenschr., 1913, 1, No. 36. 



