Sérac

“ I may, however, mention, that the idea of having recourse to this remedy in cholera, occurred to Dr. Latta, from being convinced, (which I am also,) that the evacuations upwards and downwards are in reality the serum of the blood; that it is the duty of the physician to replace it, as speedily as possible, by injecting a fluid, as similar to the serum as can be formed artificially, directly into the veins, which has been done here with wonderful, and, so far as we can yet judge, excellent effect. ”

“ My suspicions were only too well confirmed by what I saw. The substance which I had extracted from the syringe was a mass of micro-organisms, but of what nature I did not know. I had never seen any quite like them before. I drew back. ”

“ In all phases of human activity the serum seems to work wonders. “The cases are numerous in which the frigidity of both sexes have [sic] melted after Auto-Hemic treatment.” A young married woman with a morbid dislike for her husband took the serum and within a week “became normal.” ”

“ General symptoms, gummata, tertiary ulcers, tertiary lesions of skin, mucous membrane, bones, joints, etc. —Second attacks. —Inherited Syphilis —Transmission —Clinical features in infancy, in later life —Contagiousness —Treatment.
Syphilis is an infective disease due to the entrance into the body of a specific virus. It is nearly always communicated from one individual to another by contact infection, the discharge from a syphilitic lesion being the medium through which the virus is transmitted, and the seat of inoculation is almost invariably a surface covered by squamous epithelium. ”

“ As is well known, blood serum possesses, as a rule, a bactericidal power upon most micro-organisms, and we have every reason to believe in the existence of specific substances in the serum which exert some influence upon the growth and development of micro-organisms, and also upon the toxic products they tend to elaborate. These protective substances—the alexins of Buchner—appear to be proteid in nature, resembling globulins, since they are precipitated from serum by the action of certain strong solutions of alkali salts, as sodium sulphate. ”

“ And this goes on until you have left in the clot very little besides corpuscles entangled in a network of fibrin, and all the rest of the blood has been squeezed outside the clot, and is then called serum. Serum, then, is blood out of which the corpuscles have been strained by the process of clotting.
Now I dare say you are ready to ask the question, If blood clots so readily when it is shed, why does it not clot inside the body? Why is our blood ever{48} fluid? This is rather a difficult question to answer. When blood is shed from the warm body it soon gets cool. ”

“ You see, the problem was to get a drug, or serum, that would kill the germs in the body and not kill the body. They tried to fight it with other germs, to put into the body of a sick man germs that were the enemies of the plague germs--"
"And you can't see these germ-things, Granser," Hare-Lip objected, "and here you gabble, gabble, gabble about them as if they was anything, when they're nothing at all. Anything you can't see, ain't, that's what. Fighting things that ain't with things that ain't! They must have been all fools in them days. ”

“ Serum is effused into the areolar tissue of the softer swelling at the circumference.
ŒDEMA, DROPSY, ANASARCA. Even under moderate inflammation some amount of effusion takes place into the texture or from the surface of a part. This effusive serous fluid called also serosity, resembles and probably is the scrum of the blood. When this passes into the areolar structure of a part it is called œdema, (though this is not always by inflammation) and if the serosity passes out extensively over the body, the disease is called anasarca or general dropsy. ”

“ In order that it may exert this power it requires the presence of a substance normally present in the serum known as “complement.” The development of these “anti-bodies,” though it has been studied mainly in connexion with bacteria and their toxins, is not confined to their action, but can be demonstrated in regard to many other substances, such as ferments, tissue cells, red corpuscles, &c. In some animals, for example, the blood serum has the power of dissolving the red corpuscles of an animal of different species ”

“ The question of the value of preventive inoculation is, however, still an open one. So also are other applications of the principles of immunity, as the production of anti-sera for snake-venom, and for the irritant (and perhaps intoxicating) vegetable agent causing hay fever.
I have earlier in this lecture referred to methods of serum diagnosis depending on agglutination or solution of bacteria or on the precipitation of protein. Immunology has recently contributed to medicine another diagnostic method of great value. ”

“ Three men had large syringes. A lad carried a pail of fluid from which they replenished them. The red-faced man watched. They went along the room in pairs, one holding the lantern while the other knelt by the sleeper and made the injection—two strokes of the piston with a pause between. One pair came to Mr. Raynor and another to me at the same time. I was too numb to feel pain when the great syringe dug deeply into my flesh, but it was well for me that I could not scream. As it was, I made a faint sound.
“Must have been near waking,” the injector said, putting the rug over my shoulders again. ”

“ In the streptococcal inflammations spreading by the lymph channels appears to be specially prevalent. In the blood the organisms, if in small numbers, are usually destroyed by the plasma, which has a powerful bactericidal action; should they escape, however, they are carried without multiplication into the capillaries of the general circulation, of the lung, or of the liver, where, being stopped, they may give rise to a second focus of infection, especially if at the point of impaction the vitality of the tissues is in any way lowered. ”

“ This they carry back to the lungs to be cast out of the body.
There is one white blood cell to every four hundred red ones. The white cells are the body-guards. They change their shape and are able to crawl through the walls of the capillaries. Wherever the body is hurt, they collect in large numbers and eat the germs which are always trying to get into the body through sores. The white matter called pus in a sore is largely made of white blood cells which came there to fight the germs and were killed in the battle. ”

“ The accompanying illustration shows the dividing rock embossment surrounded by moraine and the wildly broken séracs extending across the glacier. The action of the glacier as an irresistible plane, shaving off the mountain side, is well depicted on the left hand. The main stream of the Yoho river issues from a fine cave which it has hollowed out in the ice-tongue. The front of the forefoot is precipitous, rising sharply about 150 feet. The slope then assumes a more gentle phase, and walking on the ice between the crevasses, which are here longitudinal, is an easy matter. ”

“ Collect blood serum in slaughterhouse, coagulate, remove serum and tube (vide page 168) .
Great care must be taken to avoid the inclusion of air bubbles—indeed if only a few tubes are filled at one time, it is a good plan to stand them upright in the receiver of an air pump and to exhaust as completely as possible before transferring to the serum inspissator.
2. Heat the tubes in a slanting position in hot-air steriliser at 90° C. till firmly coagulated, say half an hour. [Pg 209]
3. Sterilise in steam steriliser at 100° C. for 20 minutes on each of three successive days. ”

“ From no surface in the body can absorption take place quicker than from the synovial membrane of a joint. So soon, therefore, as this membrane comes in contact with septic material, so soon does a severe septic fever make its appearance. The septic matter has gained the blood-stream, and the patient succumbs to septic poisoning. ”

“ Imagine to yourself a syringe, the tube of which gives rise to an infinity of branches, which afterwards give origin successively to a number of smaller ones; if, when you push the piston of the syringe, its body and all the branches and smaller branches arising from it, are already full of fluid, it is evident that at the very instant in which the piston shall push the fluid in the body, it will go out on all sides through the open branches. ”

“ For our purpose it can be injected into the arm, with a hypodermic syringe, or even dropped on any delicate mucous membrane. We have experimented on it in every way, and are more than satisfied with the result. ”

“ In the first periods of inflammations, in which the exhalants of the serous membranes are full of blood which is preternaturally introduced into them, the serum does not ooze in greater quantity from their free surface. Then as they are on the one hand very sensible, and very dry on the other, the motions of the organs that they cover are wonderfully painful. ”

“ During this momentary crush, part of the serum being forced on too fast, oozes through the wall of the over-filled capillaries, as water oozes through the leathern pipes of a fire-engine, and hence probably the appearance of serum or lymph in the organs, where it is immediately sucked up (i. e., absorbed) by the lymphatic vessels. Now, you will easily understand that the larger the proportion of serum in the blood, the greater will be the quantity to be expelled in passing through the capillaries, and the more will the lymphatic vessels swell. ”

“ The symptoms of sapremia depend upon the amount of intoxication.
In septic infection, or septicemia, only a small number of organisms may get into the blood, but they multiply rapidly. A drop of blood from a man with septic infection will reproduce the disease when injected into the blood of an animal; hence it is a true infective disease. The wound in such a case is often small, and is commonly punctured or lacerated. ”

“ With regard to the behavior of their serum and red blood-cells, all human beings fall into one of three groups. In the first group, the red cells are not agglutinable by any other human serum, while the serum is found to agglutinate the red cells of all persons not belonging to this first group. In the second group, the red cells are agglutinated by the serums of the first and of the third groups, while the serum agglutinates the cells of the third group only. ”

“ A serum specific for rabbit’s blood serum was therefore prepared, and the stains dissolved and tested as described above. No sign of precipitate was obtained within thirty minutes after applying the test and evidence was therefore given that the stain certainly did not consist of rabbits’ blood. On the other hand, [Pg 166] a serum made specific for human blood gave an immediate precipitate with the solution of the stain, which, therefore, in all probability consisted of human blood. ”

“ Serum is also found, though in a smaller quantity, in those cases in which the anasarca has followed the local dropsy; for the disease of the viscus, which is the cause of the inflammation in the serous membrane of the cavity, may produce an adequate degree of the vascular excitement which gives rise to a discharge in the cellular tissue. Our author sums up his observations on this subject, by remarking, that there appear to be four distinct conditions of the system by which the occurrence of serum in the urine is regulated. [Pg 86]
"1. ”

“ A _polyvalent_ serum, that is, one derived from an animal which has been immunised by numerous strains of the organism derived from various sources, is much more efficacious than when a single strain has been used. ”

“ It is a fact that if the serum of an animal which has been rendered immune to a certain disease be injected into a susceptible animal, the same immunity can be produced temporarily in the second animal. ”

“ In sapremia the blood contains the toxins and dead saprophytic organisms. In septicemia the blood contains both pyogenic toxins and multiplying pyogenic organisms. In sapremia the causative condition is putrid material lodged like a foreign body in the tissues. In septic infection the tissues themselves are suppurating, and both bacteria [Pg 50] and toxins are absorbed by the lymphatics. Of course, septic infection may be associated with septic intoxication or may follow it. ”

“ It diagnoses at the very first stage. You take a small quantity of blood, derive the serum, then introduce a piece of tissue such as you wish to find out whether it is diseased or not. The thing is of overwhelming importance. One can discover a condition even before the organ itself shows it outwardly. It means a new epoch in medicine. As for me, I call it the new 'police service' of the organism—working with perfect, scientific accuracy."
"Wh-what do you find?" reiterated Seabury. ”

“ How, then, could this blood-serum have exerted a favorable change in the metabolism of the infant which was but ten weeks old? Our bacteriological friends will tell us that the benefits were due to the “natural antiseptic properties” of normal blood-serum; but the clinician and intelligent and conscientious physician will want to know from whence this peculiar property is derived. The blood is an alkaline fluid, and we are taught that antiseptic solutions, to be effective, must be acid. ”

“ From the study of the processes by which immunity is secured against the effects of bacterial action the serum and vaccine methods of treating certain infective diseases have been evolved. The _serum treatment_ is designed to furnish the patient with a sufficiency of antibodies to neutralise the infection. The anti-diphtheritic and the anti-tetanic act by neutralising the specific toxins of the disease--_antitoxic serums_; the anti-streptcoccic and the serum for anthrax act upon the bacteria--_anti-bacterial serums_. ”