Abstract
In 1930 the author attempted to produce a Shwartzman phenomenon (local hemorrhagic necrosis following local and intravenous injections of bacterial toxic filtrates with fungus extracts). These efforts were unsuccessful. In the hope that previous local injections of a vascular poison might render the reaction site more sensitive to hypothetical toxic substances in fungus cultures, snake venom was employed. This again proved unsuccessful. Later, in collaboration with Dr. Harry Sobotka, 1 the author showed that if 14 days to one month were allowed to elapse between the time of injecting of rabbits with snake venom and the elicitation of a Shwartzman phenomenon, a large number of the animals became refractory to the latter. Since no circulating antibodies could be demonstrated to explain the refractory state, and since antivenin had no effect on the course of the Shwartzman phenomenon, the induced refractory state was thought to be due to some change in the vessel walls which made them resistant to toxic filtrates and this prevented the hemorrhage. With this possibility in mind, the author then treated with snake venom diseases which can be grouped under hemorrhagic diatheses. Patients showing certain allergic phenomena such as urticaria, neurodermitis, as well as asthma and hay fever were also treated.
Clinical trial was made in 44 cases which can be divided roughly into 3 groups:
Group I consists of 3 cases of thrombocytopenic purpura, 20 one case of Henoch-Schönleins syndrome (Frank's capillary toxicosis), and 2 cases of hemophilia. The hemorrhagic purpura cases had such symptoms as epistaxis and purpura; and in 2 of them there was a history of prolonged and profuse menstrual periods. Two of this group have been under treatment with snake venom for 9 months, and one for 6 months.
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