August 25, 1916] 



SCIENCE 



261 



It is logical, therefore, to endeavor to bring the 

 immune serum in as high a concentration as 

 possible into immediate relation with the seat 

 of disease. 



The power of the immune serum, when in- 

 jected subdurally, to prevent the development 

 of experimentally induced poliomyelitis in the 

 monkey, is further indicated by experiments 9 

 in which, on the one hand, the virus has been 

 injected into the blood under conditions in- 

 suring its escape into the meninges and, on 

 the other, when an emulsion of the virus has 

 been introduced directly into the meninges and 

 followed later by the serum injection. 



SERUM THERAPY IN MAN 



This aspect of the subject has been imper- 

 fectly developed up to the present time. 

 Netter 10 was the first to apply the data ob- 

 tained by experiments on monkeys to the treat- 

 ment of cases of epidemic poliomyelitis in 

 man. He has published the results obtained 

 in a series of thirty-five cases which he re- 

 garded as highly favorable to the method. He 

 employed the serum from cases of poliomyelitis 

 in which complete recovery from the acute 

 condition has taken place some time and even 

 as long as thirty years previously. The serum 

 injections were given subdurally as early after 

 the appearance and recognition of the symp- 

 toms of poliomyelitis as possible. The dose of 

 the serum, which must, of course, be sterile 

 but need not be inactivated, should be deter- 

 mined by the age of the patient and will, in 

 part, be determined by the quantity of serum 

 available. Probably doses ranging from five 

 to twenty cubic centimeters will be found 

 suitable, the injection to be repeated once or 

 more times at twenty-four hour intervals ac- 



» Flexner, S., and Amos, H. L., ' ' Localization 

 of the Virus and Pathogenesis of Epidemic Polio- 

 myelitis, ' ' Jour. Exper. Med., 1914, XX., 249. 



io Netter, A., ' ' Serotherapie de la poliomyelite 

 nos resultants ehez trentedeux malades, ' ' Indica- 

 tions technique — incidents possibles, Bull, de 

 I' Acad, de Med., Oct. 12, 1915. Netter, A., and 

 Salanier, M., "Deux nouveaux cas de poliomyelite 

 a debut meninge gueris par les injections intra- 

 raehidiennes de serum d' aneiens malades," Bull. 

 Mem. Soe. Med. des Hop. de Paris, Mar. 10, 1916. 



cording to clinical conditions and indications. 

 The effects of the immune serum should be 

 sought in the checking of the progress of the 

 disease, namely the prevention or minimization 

 of the paralysis when employed in the pre- 

 paralytic stages, and the arrest of its exten- 

 sion when used in progressing paralytic con- 

 ditions. Since the immunity substances have 

 been determined by neutralization tests to 

 persist in the blood for many years, it is prob- 

 able as Netter has indicated that persons who 

 have passed through an attack of poliomyelitis 

 several years earlier may be utilized as sources 

 of the serum; while reasoning from analogy 

 it would probably be advantageous to prefer 

 persons whose attack was less remote so as to 

 insure as high concentration of the immunity 

 bodies as possible. The conditions surround- 

 ing the injection of the serum are identical 

 with those observed in the analogous case of 

 epidemic meningitis. Before each dose of 

 serum is injected a suitable quantity of 

 cerebro-spinal fluid is to be withdrawn, and the 

 injection should be made slowly. In choosing 

 the person who is to serve as the source of the 

 blood from which the immune serum is to be 

 derived precaution should of course be taken 

 to secure a healthy donor; it would be ad- 

 visable to fortify the usual clinical examina- 

 tion by a Wassermann test. 



Simon Blexner 



THE CULTURE VALUE OF SCIENCE 1 



Wishing not to squander any of the few 

 minutes allowed me in this program, I have 

 written down what I have to say, and hope you 

 will pardon me if by reading I seem unduly 

 formal for the occasion. 



The Scripps Institution for Biological Re- 

 search believes it has a mission over and above 

 what is indicated by its name. As " nomi- 

 nated in the bond," its function is to produce 

 new knowledge in the realms of nature with 



i Eemarks to the teachers of science in the sec- 

 ondary schools of southern California on the oc- 

 casion of their visit to La Jolla and the Scripps In- 

 stitution for Biological Research of the University 

 of California during the teachers' institute week 

 in November, 1915. 



