THE TREATMENT OF INFECTIOUS DISEASES 825 



tococci obtained from the sputum of tuberculous patients. The serum 

 of these animals is, therefore, antituberculous and also antistreptococcic, 

 and is serviceable against a mixed infection. 



The serum is administered daily, either by subcutaneous injection, 

 in doses of from 5 to 10 c.c., or by the rectum in doses of from 10 to 20 

 c.c. The latter form of administration is quite objectionable to most 

 patients, but is the one least likely to produce serum sickness. 



While this serum has been used quite extensively, the evidence at 

 present is too conflicting to permit definite conclusions to be drawn as to 

 its value in treatment. It would, however, seem to be worthy of further 

 trial in cases of localized bone and joint tuberculosis and in the incipient 

 stage of pulmonary tuberculosis. Citron recommends its use in patients 

 who evince persistent rise of temperature, and in the very severe but 

 not hopeless cases where tuberculin therapy cannot be undertaken. In 

 some of these cases he has obtained very encouraging results. Citron 

 occasionally begins with the serum treatment, and later combines tuber- 

 culin administration with it, finally omitting the serum altogether. 



THE TREATMENT OF INFECTIOUS DISEASES WITH THE SPECIFIC 

 SERUM OF CONVALESCENTS AND WITH NORMAL SERUM 



On the basis that recovery from several of the infectious diseases 

 confers a high degree of immunity due presumably to the presence of 

 specific antibodies in the body fluids and particularly the blood, numer- 

 ous attempts have been made to treat certain of the infectious diseases, 

 and particularly those for which we do not have an artificially prepared 

 serum, with serum derived from convalescents. 



Scarlet Fever. Huber and Blumenthal, 1 von Leyden, 2 Reiss and 

 Jungman, 3 Koch, 4 Rowe, 5 Zingher, 6 and others have reported favorably 

 upon the treatment of scarlet fever and particularly severe infections, 

 with injections of serum from persons who have recovered from this 

 disease. Reiss and Jungman obtained the serum from persons about 

 the third week of the disease and injected 50 to 100 c.c. intravenously. 

 Koch emphasizes the necessity of starting the treatment as early in the 

 disease as possible and injecting large doses of the serum intravenously. 

 Rowe was unable to convince himself that there were any different effects 



1 Berl. klin. Wchnschr., 1897, xxxiv, 671. 



2 Deutsch. Archiv. f. klin. Med., 1902, Ixxiii, 616. 



3 Deutsch. Archiv. f. klin. Med., 1912, cxii, 70. 



4 Munch, med. Wchnschr., 1913, Ix, 2611; Deutsch. med. Wchnschr., 1915, xli, 

 372. 



5 Med. Klinik., 1913, ix, 1978. 6 Jour. Amer. Med. Assoc., 1915, 65, 875. 



