SERUM THERAPY 149 



ized by a predisposition to profuse or uncon- 

 trollable hemorrhage which may be spontaneous 

 or induced by an injury. Hemorrhage induced 

 by the slightest wound is the chief factor, while 

 spontaneous hemorrhages are of secondary im- 

 portance and are often hard to differentiate 

 from certain forms of chronic purpura. In spite 

 of various theories advanced by Sahli, Weil, 

 Nolf and Kerry, the cause of hemophilia is still 

 shrouded in mystery ; one fact remaining, name- 

 ly, the non-coagulability of the blood or its de- 

 layed coagulation. 



Historic Among the first to use serum ther- 

 apy for hemophilia was Bienwald, who em- 

 ployed it for intractable hemorrhage from the 

 scalp in 1897. A cure resulted. Frey in 1898 

 successfully treated three cases of hereditary 

 hemophilia by subcutaneous injections of Nor- 

 mal Horse Serum. Welch in 12 cases of hemo- 

 philia neonatorum obtained successful results, 

 when previously 17 out of 18 cases treated with 

 calcium, gelatin, or adrenalin had died. Weil 

 has perhaps attained the best work in connec- 

 tion with this form of treatment. In one pa- 

 tient he succeeded in shortening coagulation 

 from 4Vj hours to 40 minutes. 



