INFECTIOUS DISEASES 191 



which they claim to have obtained results equally as satisfactory 

 as from the specific serum injections. 



ERYSIPELAS 



The treatment of erysipelas by means of antistreptococcal serum, 

 usually by subcutaneous injections, is by no means a recent procedure, 

 nor one concerning the value of which an agreement has been reached 

 by clinicians. Chantemesse used Marmorek serum in some 500 cases 

 and gained the impression that the process of recovery was accelerated. 

 After 24 hours the swelling, induration and pain began to diminish 

 while within a few hours after the injection the general condition 

 of the patient improved. Jochmann, who had a considerable experi- 

 ence, concluded that where the local inflammation was to be influ- 

 enced, subcutaneous therapy was valueless, but that in the severely 

 toxic cases with delirium, rapid pulse, etc., the effect of the serum was 

 manifest in improving the general condition. 



Since the introduction of the intravenous methods of administra- 

 tion of antistreptococcus serum, or with nonspecific methods, one can 

 determine a more marked effect on the disease, both locally and in 

 the general effect on the patient. Together with Jobling and Manier 

 we commenced the treatment of erysipelas in 1915 with proteoses in- 

 jected intravenously. The results in several cases have been presented 

 by Jobling. Since that time the writer has had opportunity of ob- 

 serving a series of about 15 additional cases treated either with prote- 

 oses, milk, or typhoid vaccine and the results have in all cases been 

 very satisfactory, indeed in some cases seemingly quite remarkable. 

 The rapid subsidence of the intoxication, the general improvement of 

 the sensorium and cardiovascular apparatus gave striking evidence 

 of the decrease in the intoxication. The local process is also influenced, 

 usually not, however, until there is evidence of the systemic effect in 

 the euphoria and lessening of the toxicity of the patient. 



French clinicians have used subcutaneous injections and oral ad- 

 ministration of normal serum as well as diphtheria antitoxin in the 

 treatment of erysipelas for a number of years (Launois, Darier, 

 Apostolleaun, Pollak and Mayweg) with some success, but in recent 

 years the intravenous injection of such sera has evidently been fol- 

 lowed by more apparent effects on the course of the disease. Koller, 

 Uhlig, Basset, Campani, Frank and Bugolli report on cases so treated 

 and Boyksen, who used normal horse serum, treated a rather large 

 series. In severely toxic or extensive infection he administered 20 

 c.c. ' intravenously together with 10 c.c. subcutaneously ; in the milder 

 cases only 10 c.c. was given intravenously. 



The colloidal metals have also been employed, at times with suc- 

 cess. (Eberstadt, Cholewa, Capitan, etc.) 



Holler calls attention to a fact which we have observed at vari- 



