SERUM SICKNESS 139 



and even of death, have been reported following 

 the injection of diphtheria antitoxic serum. Rose- 

 nau and Anderson have collected nineteen such 

 sudden death cases from the literature, and state 

 they have personal knowledge of several more 

 which have not been reported. However, con- 

 sidering the enormous number of antitoxic injec- 

 tions made each year, such accidents must be 

 extremely rare. Certainly the benefits derived from 

 diphtheria antitoxin far outweigh the danger. 

 In over 50,000 persons injected in New York, but 

 two deaths attributed to the serum furnished by 

 the Health Department, have occurred. 



Due to Serum as Such. Heubner in 1894 and 

 von Bokay somewhat later expressed the opin- 

 ion that these manifestations were due to other 

 properties than the antitoxin in the serum, and 

 this has proven to be the case. Johannessen pro- 

 duced the same effects by injecting normal horse 

 serum. It has also been shown that the skin erup- 

 tions and other symptoms follow in direct propor- 

 tion to the amount of serum injected, and this has 

 led to attempts to concentrate the serum as much 

 as possible. 1 Park has also shown that the individ- 

 uality of the horse plays an important r61e, some 

 horses yielding a serum which gives rise to a large 

 proportion of " rashes." 



1 See Gibson, The Concentration of Diphtheria Antitoxin, 

 Jour, of Biological Chemistry, Vol. i, 1906. 



