830 SERUM THERAPY 



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. 311.) Of course, all pro- 

 cedures should be conducted in an aseptic manner. 



Blood Transfusion. Instead of injecting serum intravenously or 

 whole blood intramuscularly in the treatment of the anemia following 

 excessive hemorrhage, the transfusion of whole blood is frequently 

 resorted to with excellent results. Transfusion has been employed in 

 (a) the treatment of severe anemia following hemorrhage from injuries, 

 operations, and child-birth; (6) in the severe anemias following single 

 or repeated hemorrhages in typhoid fever, gastric ulcer, carcinoma, 

 tuberculosis, or similar ulcerating processes; (c) in melena neonatorum, 

 hemophilia, and purpura hemon-hagica; (d) in the treatment of perni- 

 cious anemia and severe anemias of the chlorotic type; (e) in illumin- 

 ating gas poisoning, and (/) in the passive transfer of antibodies, as the 

 transfusion of blood from a typhoid convalescent to a person suffering 

 with typhoid fever. The best results have been observed in melena 

 neonatorum, in which disease transfusion often acts as a specific remedy. 

 In hemophilia the bleeding may be stopped, but the disease is not cured. 

 In gastric ulcer and other ulcerative conditions complicated by repeated 

 hemorrhages surgical intervention followed immediately by transfusion 

 has yielded successful results. In pernicious anemia the benefit follow- 

 ing transfusion is only temporary; repeated transfusions are usually 

 necessary, and splenectomy followed or immediately preceded by trans- 

 fusion is sometimes employed. 



In transfusion the person yielding the blood is known as the donor, 

 while the person receiving it is known as the recipient or donee. In select- 

 ing a donor it is important that his blood be compatible with that of the 



