140 MODERN BIOLOGIC THERAPEUSIS 



duced directly into the subarachnoid space by 

 means of lumbar puncture, so that it will be 

 brought into close contact with the infected 

 area. 



A study of the results obtained in some 13,000 

 cases convinced Flexner that the serum should 

 be administered intraspinally by the gravity 

 method, and this is now advocated by most cli- 

 nicians in this country and abroad. The con- 

 tainer illustrated on page 145 has been espe- 

 cially devised for the express purpose of 

 supplying a means for this method of adminis- 

 tering the serum. 



Dosage The quantity of serum introduced 

 should usually be slightly less than the amount 

 of fluid withdrawn. The dose is usually 5 to 15 

 c.c. in infants and children, and 30 c.c. or more 

 in adults. The injections of the serum are to be 

 repeated at intervals of 24 hours, and each in- 

 jection is to be preceded by withdrawal of cere- 

 brospinal fluid. Usually four to six injections 

 of 5 to 15 c.c. each, at intervals of 24 hours, are 

 required for infants and children; and a like 

 number of injections of 30 c.c. each, at the same 

 intervals, are necessary for adults ; but as many 

 as 15 or more doses may have to be given. If 



