256 PASSIVE IMMUNIZATION 



of cancer cases in the treatment of the corresponding patients, but 

 likewise without any lasting benefit. 



Autoserum Therapy in Syphilis of the Central Nervous System. 

 Of late the patient's own serum has been advocated in the treat- 

 ment of syphilitic diseases of the central nervous system, the serum 

 being administered by the subdural route, and obtained from the 

 patient one hour after an intravenous injection of salvarsan. The 

 underlying idea is to bring both the salvarsan and any antibodies 

 that may be formed in the patient's own body into as intimate a 

 contact as possible, with the spirochetes, located in the perivascular 

 lymph spaces and the adventitia of the bloodvessels. This plan 

 seems thoroughly logical and deserves extended investigation. 

 That protective antibodies are actually present in the blood serum 

 of treated syphilitic patients has been demonstrated beyond a 

 reasonable doubt. It has thus been observed by Taege that the milk 

 of syphilitic mothers, after treatment with salvarsan, develops 

 curative properties for the infected infants, and other investigators 

 have noted marked improvement in adults following the injection 

 of the serum of treated syphilitic individuals. The effects, however, 

 were not lasting, and it hence appears rational to combine the use 

 of the salvarsan with that of the serum. The salvarsan, moreover, 

 when given by itself, by the subdural route is too irritating to warrant 

 its use in this manner, while in combination with serum this objec- 

 tionable effect apparently falls away. 



Technique. The procedure which has been advocated by Swift 

 and Ellis is the following: One hour after an injection of salvarsan 

 or neosalvarsan, 50 c.c. of blood are withdrawn from one of the veins 

 at the bend of the elbow, to which end a MacRae puncture needle 

 will be found most convenient, the blood being aspirated directly 

 into large tubes. The serum is allowed to separate out overnight 

 (in the ice-box), and the following morning is diluted to 40 per 

 cent, with normal saline. At that time approximately 15 c.c. of 

 spinal fluid are withdrawn and replaced by 30 c.c. of the diluted 

 serum, which has previously been heated for one-half hour at 56 C. 

 and then brought to the temperature of the body. The patients are 

 kept in bed for twenty-four hours, the foot end being raised for 

 about one hour following the treatment. 



After two or three weeks the injection is repeated and so on, 

 according to the symptoms of the individual case. As a rule there 



