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On the Supersensitation of Persons by Horse-serum

Published online by Cambridge University Press:  15 May 2009

E. W. Goodall
E. W. Goodall
Affiliation:
Medical Superintendent of the Eastern Fever Hospital, Homerton, London.
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1. There were 90 patients at the Eastern Hospital, who, during the years 1897, 1898, 1899, 1904, 1905 and 1906, were injected with horseserum for a second attack or relapse of diphtheria, who had been treated with horse-serum at the first attack.

2. Of these 9 had an “immediate reaction,” 22 an “accelerated reaction,” and 8 had both, 39 in all, or 43·4 per cent.

3. The “immediate reaction” showed itself a few minutes to six hours after the first injection for the second attack.

4. The shortest interval between the first injection at the primary attack and the occurrence of an “immediate reaction” after a reinjection for a second attack was 35 days; the longest was 363 days.

5. The ”accelerated reaction” showed itself 19 hours to five days after the first injection for the second attack.

6. The shortest interval between the first injection at the primary attack and the occurrence of an “accelerated reaction” after a reinjection for a second attack was 25 days; the longest was 1511 days. In each of these cases the reaction occurred the day after the reinjection.

7. In seven of the cases of “immediate reaction” the symptoms were severe. In all save one of those of “accelerated reaction” they were mild or moderate.

8. In 24 of the cases there was a normal serum-reaction after the reinjection for the second attack; but even this occurred in most cases slightly earlier than is usual after injection at a primary attack.

9. So far as the figures go they show:

(a) that when a patient has had a serum-reaction at the primary attack, he is more likely to have an abnormal reaction after injection at the second attack;

(b) that the greater the volume of serum given in the primary attack, the more likely is an abnormal reaction to occur after serum at the second attack;

(c) and that consequently an abnormal reaction is most likely to occur after serum at a second attack when the patient has had a large volume of serum followed by a reaction at the first attack.

There are, however, indications that the volume of serum given at the primary attack may have different effects as regards the determination of an “immediate” or an “accelerated reaction,” according to its amount.

Type
Research Article
Information
Journal of Hygiene , Volume 7 , Issue 4 , July 1907 , pp. 607 - 618
Copyright
Copyright © Cambridge University Press 1907

References

page 607 note 1 See Encycl. Medica, Vol. III. p. 18.

page 607 note 2 See Clin. Soc. Trans. Vol. XXXI.

page 608 note 1 I have notes of a few cases in which patients received np to eight injections of serum within a few days without any hastened serum-reaction, sometimes without any reaction at all. One patient received 200 c.c. in eight injections during 11 days, and had no reaction.

page 608 note 2 Clin. Soc. Trans. Vol. xxxin.

page 613 note 1 I have not seen an abnormal reaction take place between 6 and 19 hours after an injection; hence I have taken 12 hours as the limit of an “immediate reaction.”