AUTOSERUM THERAPY 781 



AUTOSERUM IN THE TREATMENT OF TUBERCULOSIS OF SEROUS MEMBRANES 



Numerous investigators, as, for example, Gilbert, 1 Marcon, 2 

 Schnutgen, 3 Fishberg, 4 Pfender, 5 Robertson, 6 and others, have reported 

 favorable results in the treatment of tuberculous pleurisy with effusion, 

 cases that arise either insidiously or abruptly with pain in one already 

 tuberculous, or in one in whom tuberculosis is suspected, following 

 withdrawal of a portion of the fluid and immediate injection of from 2 

 to 5 c.c. into the subcutaneous tissues. In these cases there is usually 

 a sharp reaction, consisting of a rise in temperature, occasionally ac- 

 companied by chill, lassitude, and, in the majority of cases, diuresis or, 

 more rarely, diarrhea, followed by gradual absorption of the fluid within 

 the following few days up to two or three weeks. Fishberg mentions the 

 disappearance of pain, dyspnea, and prostration within two or three 

 days in favorable cases. 



It is difficult to state whether the improvement is due to autotherapy 

 or simply to the puncture and removal of so much fluid. Eisner 7 has 

 seen a leukocytosis follow injection of serum in experimental tuberculous 

 infections of rabbits and guinea-pigs, and believes that this explains the 

 good results in this particular form of therapy. Zimmermann 8 has ex- 

 pressed a similar opinion. Other investigators assert their belief in the 

 presence of aggressins, bacteriolytic amboceptors, complements, and 

 endolysins from disintegrated leukocytes as explaining the results. It 

 is more likely that these fluids contain the bacilli or their products, and 

 constitute a form of vaccine or auto-tuberculin, stimulating body-cells 

 to produce antibodies largely in the nature of bacteriotropins and bac- 

 teriolysins. Levy, Valenzi and Ponzin, 9 Szurek, 10 and Arnsperger 11 are 

 inclined to believe that the beneficial results are obtained independently 

 of the injections, and while the procedure is quite generally regarded as 

 perfectly safe, Jousset 12 has recorded a case of cold abscess following an 

 injection. This mode of treatment seems to have failed in about 10 to 

 15 per cent, of cases. 



The technic is very simple, and the injections may be given by any 



1 Gaz. des Hopit., 1894, 560. 2 La Presse Mddicale, 1909, No. 71, 627. 



3 Berl. klin. Wochenschr., 1909, No. 3, 97. 



4 Jour. Amer. Med. Assoc., 1913, Ix, 962. 



5 Wash. Med. Ann., 1914, xiii, 83. 6 Personal communication. 



7 Zeitschr. f. klin. Med., 1912, Ixxvi, 34. 



8 St. Peters, med. Wochenschr., 1909, No. 34, 461. 



9 Bull. et. Mem. de la Soc. d. Hop. d. Paris, 1910, xxvii, 265. 



10 Med. Klinik, 1909, No. 44, 1665. n Therap. d. Gegenwart, 1911, Hi, 495. 

 12 Arch. Gen. de Med., 1912, xci, 141. 



