THE NONSPECIFIC AGENTS 17 



serum drawn from the clot (or after centrifuging the defibrinated 

 blood) is reinjected intravenously, usually once or twice during the 

 course of the week. Little or no reaction follows the procedure and 

 the therapeutic success is not very brilliant, considering the amount 

 of time consumed, with tho manipulation. Perry substituted horse 

 serum with seemingly good results. 



Normal Animal Serum. Horse serum, beef serum, goat serum, 

 sheep serum, chicken serum, to mention but a few that have been 

 used, were first injected subcutaneously, in more recent years intra- 

 venously; the dosage that can be used with safety varies with the 

 serum, its age, method of preparation, whether preservatives have 

 been added and the sensitization of the patient. As much as 250 c.c. of 

 beef serum have been given intravenously (in anthrax) without injury; 

 indeed the larger doses have in most cases been more satisfactory 

 than the smaller ones. The reaction to these serums is as a rule very 

 mild, only occasionally is a fever and chill observed. Before in- 

 jecting serums of this type a skin test should be made to determine 

 whether the patient is possibly sensitive to the serum the use of 

 which is contemplated. With repeated doses the reaction, contrary to 

 the result with many of the other nonspecific agents, may become 

 more severe, even when the injections are made within the time period 

 usually alloted before active sensitization will occur. Intravenous in- 

 jections must always be made very slowly even when there is no 

 evidence of sensitization. If the patient has become sensitive great 

 caution must be observed, although Smith has made use of the fact 

 that patients become sensitized to serum injections, for therapeutic 

 results. He found that when patients became sensitive to serum in- 

 jection and reacted with some temperature increase and a general sys- 

 temic reaction, a definite curative effect was to be observed on local 

 inflammatory conditions (gonorrheal complications). Normal serum 

 was recommended for injection in cases of diphtheria by Bertin as 

 early as 1895. 



Immune Serum. The use of the serum of convalescent patients 

 for injection either subcutaneously or intravenously is a procedure 

 that also dates back for a considerable time. It was used in typhoid 

 fever with some success but the most extensive application has possi- 

 bly been in the treatment of scarlet fever, and more recently in the 

 treatment of influenza. To be used successfully large doses must be 

 employed and the treatment given early, two facts that suggest very 

 strongly that the effect is due less to any antitoxic or antibacterial 

 property of the serum, than to the nonspecific stimulating effect of 

 the serum proteins. 



Weisbecker had used subcutaneous injections of convalescent serum 

 in scarlet fever in 1897, but the method was not extensively used until 

 Reiss and Jungmann emphasized the value of the treatment with 

 larger doses. From 80 to 100 c.c. of serum are now commonly em- 



