Abstract
During the treatment of cases of cerebrospinal meningitis with antimeningococcic serum in a large Army hospital, 2 a curious reaction was repeatedly observed. This appeared in patients who, after having received several intraspinous treatments with serum, were given serum intravenously. While such injection was made into the blood stream, or immediately thereafter, some of the following signs and symptoms frequently appeared: flushing, sudden feeling of warmth, restlessness,—then, pallor, dyspnea, cyanosis, vomiting, and prostration. Epinephrin and atropin hyperdermatically, induced relief. These manifestations, apparently anaphylactic, occurred only after several days of intraspinous treatments had elapsed before initial intravenous serum therapy, but had no relation to the time of the last intraspinous injection. They were not noted when combined intravenous and intraspinous therapy was applied from the outset. Similar observations are described by Stone and Truit 1 in their report of a large series of cases of meningitis at Camp Funston, and Haden 2 confirms them in one of his case reports of meningitis.
With this experience in mind, horse serum was injected into rabbits intraspinously, and the resulting precipitin formation in the blood was compared with that induced by similar intravenous injections. In a few instances, anaphylactins were studied.
Normal horse serum, without preservative, was used throughout these experiments. This was injected into the subarachnoid space of rabbits by introducing a No. 24 Luer needle attached to a glass syringe, through a sterile field just below the occipital ridge in the mid-line. The needle was carried forward and slightly downward until it punctured the occipito-atlantoid ligament. A yield of from 0.5 C.C. to 1.0 C.C. of spinal fluid was thus readily obtained. Leaving the needle in place, and disconnecting the syringe, a second syringe with a correct amount of serum was then attached.
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