198 PROTEIN THERAPY 



no benefit could be detected. Under any conditions the effect did 

 not much surpass that from the ordinary measures, drugs, vaccines, 

 fixation abscess, mercuric chlorid by the vein, etc. But the harmless- 

 ness of this milk form of protein therapy, its availability, and its ex- 

 cellent influence in reducing objective and subjective pain and in en- 

 hancing the defensive powers of the organism, impose its use on a large 

 scale, he declares, especially during the early stage, when it is most 

 potent. 



SCARLET FEVER 



The treatment of scarlet fever by means of serum injections dates 

 from the year 1897 when both v. Leyden and Weisbecker used the 

 serum of convalescent patients in a series of patients ill from scarlet 

 fever. Jochmann and Rumpel in 1903 tried subcutaneous injections, 

 using a dose of about 20 c.c., without obtaining results that were par- 

 ticularly striking. Indeed the results from subcutaneous injection have 

 in general been rather unsatisfactory, unless huge doses are used. 

 It was not, therefore, until Reiss and Jungmann published their pa- 

 per some years later that more attention was given the subject. 

 Since that time Russian and Austrian clinicians have reported ex- 

 tensively on the use of antistreptococcus serum, with at times excel- 

 lent results. Apart from convalescent serum, the antistreptococcus 

 serum of Moser, prepared by immunizing horses with strains of 

 streptococci freshly isolated from fatal cases of scarlet fever, has 

 met with considerable success (Axenow). 



In the earlier period the serum was given subcutaneously and 

 the results were never striking. Reiss and Jungmann, however, used 

 their serum intravenously and with this method of injection the re- 

 sults have been much more satisfactory. Convalescent serum being 

 rather difficult to obtain in large quantity the injections have been 

 limited as a rule to about 20-90 c.c., while with other serums the dosage 

 has been much larger, several hundred c.c. being used. Jochmann, 

 who followed this form of therapy for a number of years, considers 

 that intravenous serum injections, if given early in toxic cases, lessen 

 the toxicity, usually hasten defervescence and seem to lessen the 

 number and severity of postscarlatinal complications. 



Synnott has also reported on the use of convalescent serum and 

 Weaver has discussed the question fully. 



Glaser has recently reported a series of grave scarlet fever cases 

 treated with pooled convalescent serum. In 15 cases it was given intra- 

 muscularly in doses of from 50-80 c.c. In 40% of these cases the 

 temperature came down by prompt lysis. Complications did not seem 

 to be influenced by the treatment. In 28 cases in which the serum 

 was administered intravenously the effect on the temperature curve 

 was apparent in every case. Occasionally the intravenous injection 

 was followed by a chill, some headache and temporary weakness, but 



