A review of the serum treatment of infectious diseases in the practice of the City of Glasgow fever and small-pox hospitals, Belvidere / by John Brownlee.

  • Brownlee, John, 1868-1927.
Date:
[1908]
Catalogue details

Licence: In copyright

Credit: A review of the serum treatment of infectious diseases in the practice of the City of Glasgow fever and small-pox hospitals, Belvidere / by John Brownlee. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    6/14 (page 4)
    so that consequently it is necessary to inject large quantities (250 cubic centimetres) intravenously if the full benefit is to be obtained. In milder cases, ho'Vi'ever, the subcutaneous method was found sufficient if the serum was injected under the skin into the region of which the lymphatic vessels drain directly into the plague-infected bubo. This delay of absorption is a feature which, so far as I know, has not been pointed out, and as the phenomenon suggests the distribution of the remedy to the affected parts by living white cells, it has some interest from the point of view of immunity. To give the complete evidence on which this opinion is based is not possible in this paper, but one of the cases affords so complete a picture of the phenomenon that it is quoted here. “ N. T., female, set. 10, admitted on 11th September, 1901, in the evening. Illness began on day prior to admission with severe headache and malaise. At the same time the right groin was complained of as being, painful and tender, but the patient could walk. The temperature on admission was 102'8°F. The pulse numbered 128 per minute, and the respirations 26. The face was heavy looking and' flushed. The pupils of the eyes were contracted and the conjunctivae suflused. The lips were dry, as also the tongue, which was furred. A mottling on the skin was noted over the abdomen, flanks, arms, and legs. The spleen was slightly enlarged. A bubo, consisting of several enlarged lymphatic glands, was noted in the right groin. It was very tender. A smaller similar bubo also existed in the left gi'oin. A plague pustule was observed on the left iliac crest, with a red areola of about three quarters of an inch in diameter. In the front of the left thigh a second though very small pustule was also noted. In the former, degenerated plague bacilli were observed and a typical growth obtained on culture. On the morning of 12th September the patient was somewhat worse. The buboes in both groins had advanced, but that in the right side was much the larger. Forty c.c. of Yer.sin’s serum were injected into the subcutaneous tissue of the anterior aspect of the right thigh, and an additional 100 c.c. into the areolar tissue of the abdominal wall. Next day little change was seen in the patient’s condition, but the bubo on the right side was much smaller and less tender to touch. Tlie pustule over the left iliac crest was healing, but the one on the right leg developing. The latter was opened and dressed with a moist carbolic (1 in 40) dressing. On 14th September, the tempera- ture was beginning to fall, but though the bubo in the right groin had greatly diminished and was no longer tender, that