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Heinrich K . — Three years old. June 13, 1902. 100 c. c. scarlet-fever serum. On the 
eighth day following the injection, symptoms of the serum disease appeared which lasted 
until the twenty-sixth day. 
July 7. Thirty-four days following the first injection, 1 c. c. antidiphtheric serum 
injected into the left arm. The same afternoon urticaria and swelling of the lips. The 
next morning the arm was highly edematous. 
Alexandrine K. Xine years old. May 28, 1902. 180 c. c. normal horse serum. Eleven 
days after the injection severe symptoms appeared, which lasted until June 17. 
Sixteen days following the first injection, given 1 c. c. diphtheric antitoxic serum in the 
right forearm. Next morning, the hand swollen, very painful, and smartly to such an 
extent that the infection was considered of an erysipelatous nature. All redness and 
swelling disappeared in a few days. 
Elizabeth K. Six and one-half years old. May 3, 1902. Given 180 c. c. scarlet-fever 
serum. May 15, ten days following, sudden rise of temperature, 39.4° C. Swelling of the 
lymph nodes. Xo exanthem. 
Xineteen days after the first injection 50 c. c. scarlet-fever serum, following which occurred 
severe and painful edema of the skin of the abdomen, which spread to the labia and thighs, 
and disappeared in about a week. 
Franz Z. June 6, 1903. 1 c. c. antidiphtheric serum. June 16 had urticaria, about 
nine days after the injection. August 2, eight weeks after first injection again given 5 c. c. 
antidiphtheric serum. Shortly following, urticaria and swelling of the face. 
Frieda Z. June 10, 1903. 1 c. c. antidiphtheric serum. June 26, sixteen days following, 
the same injection repeated and acted in all respects similar to the above case, Franz Z., 
her brother. On August 2 she was again given 5 c. c. antidiphtheric serum. One hour 
later her face became red and swollen. The lids became so edematous that she could not 
open her right eye. In two hours there was general urticaria. Temperature, 38.6° C. 
Moderate swelling, locallv. 
Elli M. Four months old. First injection June 20, 1904. 12 c. c. antidiphtheric 
serum. Ten days later sudden rise of temperature 39° C. and urticaria. The fever lasted 
two days. Eruption later became measle-like and remained several days. 
Xineteen days after the first injection 5 c. c. antidiphtheric serum. One hour after this 
severe general urticaria. From the site of injection, swelling of the skin of the abdomen. 
In the afternoon the temperature rose to 39.5° C.; frequent vomiting. 
Leopoldine K. December 1, 1903. 5 c. c. horse serum. Twenty-seven days following 
the first injection, patient received 1 c. c. antidiphtheric serum. One hour following this 
last injection, definite swelling of the right hand, which later spread to the entire arm. 
AH these eight cases show this in common, that after the first 
injection of horse serum, the symptoms of the serum disease appear 
after the normal period of incubation, namely, between the eighth 
to thirteenth day. But when the same individuals are again injected 
with horse serum after intervals of sixteen to forty-two days, there 
reappears at once, or at least within twenty-four hours, symptoms 
of the serum disease. * 
Von Pirquet and Schick further give a list of 60 children who 
were injected with antitoxic horse serum at intervals from six days 
to seven and a half years between the first and second injections. 
They found that when the second injection was given from fourteen 
days to four months after the first injection they obtained, with 
great regularity, what they termed ‘‘the immediate reaction,” but 
