634 The Philippine Journal of Science 1921 
serum daily, although it can be given in greater amount and 
more frequently without any danger. In many instances the 
serum could not be retained long; in such event another 
serum enema should be given. These nine cases all recovered. 
SECOND SERIES 
Serum per rectum and intramuscular injection. — In this series 
I was able to apply the combined method (per rectum and 
intramuscular) in ten cases, all severe; there were two deaths 
giving a mortality rate of 20 per cent. All these cases were 
very severe on admission. 
THIRD SERIES 
Intramuscular injection alone. — This series comprised sixty- 
four patients who were all classified as of the severe type. There 
were five deaths, giving a mortality rate of 7.81 per cent. The 
usual site of injection is the buttock. The dosage employed was 
from 20 to 60 cubic centimeters daily, depending upon the se- 
verity of the case and the supply of serum. Later, however, 
I employed the dosage of 20 cubic centimeters every four hours 
for the first three days after admission, and 20 cubic centimeters 
twice a day thereafter. I found this method very efficacious. 
FOURTH SERIES 
Intramuscular and intravenous injection. — In the fourth 
series I was able to try this combination (intramuscular and 
intravenous) on thirteen cases, all very severe, some collapsed; 
five cases died, giving a mortality rate of 38.46 per cent. One 
case died twelve hours after the intravenous injection. This 
particular case was in a state of collapse before the serum was 
given. The other four cases died from two to four days after 
the administration of serum intravenously. 
FIFTH SERIES 
Intravenous injection alone. — This method was tried on nine 
cases, all severe and two collapsed. All these cases recovered. 
The dosage employed was 10 to 20 cubic centimeters daily, 1 
cubic centimeter being injected four to six hours previously so 
as to avoid anaphylaxis. 
The intravenous method should be done under rigid asepsis. 
The place of injection is usually the anterior cubital fossa where 
the veins are commonly prominent. It is done in closed method. 
There is great difficulty, however, in performing the closed 
