836 SERUM THERAPY 



and by Mordinos 1 in that of typhoid fever, influenza, and Malta fever. 

 Other observers have also reported good results following the injection 

 of from 5 to 10 c.c. of the patient's serum in the treatment of gonorrheal 

 arthritis, typhoid fever, pneumonia, and other infections. Robertson 2 

 states that he has never observed the slighest influence of autoserum 

 injections in the treatment of typhoid fever and pneumonia. Palmer 

 and Secor 3 have reported favorable results in the autoserum treatment 

 of a series of cases of pellagra, and Goodman 4 in the treatment of chorea. 



AUTOSERUM (SALVARSANIZED) IN THE TREATMENT OF SYPHILIS OF THE BRAIN 



AND SPINAL CORD 



The treatment of syphilis of the central nervous system has always 

 been unsatisfactory. With the discovery of salvarsan and neosalvarsan, 

 the hope was fostered that these remedies would prove of therapeutic 

 value in the treatment of tabes dorsalis, paresis, and cerebrospinal 

 syphilis. Experience has shown, however, that while the progress of 

 tabes dorsalis may be arrested in the early stages by vigorous treatment, 

 in paresis the prognosis is much less hopeful. As these diseases are now 

 known to be truly syphilitic, the presence of Treponema pallidum having 

 been actually demonstrated in the cerebral cortex, spinal cord, and 

 cerebrospinal fluid by Noguchi and Moore, Nichols, Graves, Marie, 

 Levaditi, and others, the cause for failure in the treatment of these in- 

 fections must be ascribed largely to the fact that the choroid plexus 

 filters out salvarsan and mercury, as well as antibodies, and prevents 

 these remedies from reaching the cerebrospinal fluid, just as it prevents 

 the entrance of serum, albumin, sugar, urea, ammonia, etc. Although 

 there can be no doubt as to the spirocheticidal properties of salvarsan, 

 and as to its ability to kill the treponema in the tissues, this much-desired 

 action does not seem to occur mainly because the drug cannot gain ac- 

 cess to the parasites. 



Shortly after the discovery of salvarsan and neosalvarsan hope was 

 entertained that these remedies; when injected intraspinally, would 

 bring the drug into direct contact with the injected tissues. Investi- 

 gations by Wechselmann, 5 Marinesco, 6 and Ellis and Swift 7 have shown, 



1 La Presse Medicale, 1911, xix, No. 96, 1009. 



2 Personal communication. 



3 Jour. Amer. Med. Assoc., 1915, 64, 1566. 



4 Archiv. of Pediat., 1916, xxxiii, No. 9. 



5 "Ehrlich-Hata 606," Berlin, 1911, 11. Deut. med. Wchnschr., 1912, xxxviii, 

 1446. 



6 Diatet. u. physik. Therap., 1913, xvii, 194. 



7 Jour. Exper. Med., 1913, xviii, 428. 



