640 The Philippine Journal of Science 1921 
the case of bacillary dysentery these nonspecific substances might 
be produced, especially when the serum is given intravenously, 
and some of the beneficial effects that were obtained might be 
due to them. 
COMPLICATIONS 
In this series of one hundred five cases treated with serum, 
no symptoms have been observed referable to serum sickness. 
Lately, however, I have observed in three cases certain bad 
symptoms of which the serum might have been the cause. 
The first case was an adult, a healthy and robust man. He 
received two intramuscular injections of 20 cubic centimeters 
of serum with an interval of twenty hours between injections. 
One hour after the second injection, the patient felt very weak, 
became restless, had subnormal temperature, cold perspiration, 
and small, rapid pulse. Breathing increased in rate. He died 
twenty-four hours after the onset of these symptoms. 
The second case was a female nurse. She is a fairly developed, 
healthy woman. She developed urticarial rash all over her body, 
accompanied by sudden rise of temperature, and pain in the 
joints, more marked in the extremities and the jaws; so much 
so that she could hardly open her mouth or move her extremities. 
She was receiving the serum intramuscularly, 20 cubic centi- 
meters daily, and the symptoms were observed on the eighth 
day. She recovered. 
The third case was also a female nurse. She is a very well- 
developed, very stout woman. For four days she was receiving 
20 cubic centimeters of serum intramuscularly daily. Two and 
a half hours after the last injection, she felt very weak, became 
restless, moaned continuously, and had subnormal temperature, 
cold extremities, cold perspiration, and weak and rapid pulse. 
She remained in this condition for twelve hours, after which 
time she gradually recovered. 
CONCLUSIONS 
The serum can be employed in a variety of ways; namely, 
per rectum alone (enema) ; intramuscularly; intravenously; in 
combined form, as per rectum and intramuscularly, etc. 
The use of the serum per rectum (enema) is as yet limited; 
it produces beneficial effects in certain cases when the intestines 
become less irritable after starch enema with laudanum. The 
intravenous method produces immediate effects (better than 
the intramuscular injection), bu,t should be used with great 
caution, for there is danger of subsequent embolic formations 
