Brain abcess of undetermined etiology : report of four cases with recovery / Joseph C. Yaskin [and others].

Date:
[1938?]
Catalogue details

Licence: In copyright

Credit: Brain abcess of undetermined etiology : report of four cases with recovery / Joseph C. Yaskin [and others]. Source: Wellcome Collection.

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    TREATMENT OF HEMORRHAGE AND TRAUMATIC SHOCK BY THE INTRAVENOUS USE OF LYOPHILE SERUM * Douglas D. Bond, A.B., and David G. Wright, A.B. Philadelphia, Pa. FROM THE MEDICAL DEPARTMENT OP THE UNIVERSITY OF PENNSYLVANIA, DIRECTED BY DR. H. C. BAZETT, AND DR STUART MUDD, AND FROM THE DEPARTMENT OP MENTAL AND NERVOUS DISEASES OP THE PENNSYLVANIA HOSPITAL, directed BY JOSEPH HUGHES Methods for the preservation of normal blood serum in desiccated form have been developed by Elser, Thomas, and Steffen,^ by Reicbel and his asso¬ ciates, and by Flosdorf and Mudd.^ Essentially this procedure is one of rapid freezing at a very low temperature and rapid dehydration from the frozen state under high vacuum. This leaves in dry form all the solid elements of serum. The proteins appear to be unaltered and their antibody properties are preserved in full titre. In this form serum may be preserved for extended periods and is readily dissolved in water to make an isotonic or hypertonic solution. Because of its rapid solubility this product is called 'dyophile.” Eor intravenous use serum must be processed twice by this method, with an intermediate filtration to remove fat particles.^ In these experiments we have used solutions of lyophile serum intravenously to treat animals which were moribund after experimental shock and hemor¬ rhage. This use has been suggested by Hughes, Mudd, and Strecker,^ on the basis of their intravenous use of hypertonic lyophile serum in human and animal subjects for lowering cerebrospinal pressure. Hughes has treated a case of shock with serum in conjunction with blood transfusion. The decrease in circulating blood volume found in secondary shock is re¬ garded as a centrally important occurrence in this syndrome. The mechanism by which this reduced blood volume is achieved is not completely understood, ljut there exists considerable knowledge as to what are the most important sub¬ stances lost from the blood stream. Johnson and Blalock,^ in agreement with earlier workers, have stressed that the plasma was the portion of the blood that was most severely reduced and that in this severe plasma loss it was the escape of the plasma proteins that was of most importance. Clinical treatment of patients suffering from surgical shock has been di¬ rected largely toward the restoration of the blood volume in general and of the plasma proteins in particular. By far the most satisfactory and most logical substance used for this purpose has been whole blood. As whole blood must be typed, is expensive, and is not always readily available, other substances have been substituted with considerably less therapeutic success. The best of these is acacia, used in a solution osmotically similar to plasma, but it occasionally has toxic properties that weigh against its use. The deleterious * Aided by a grant from the Markle Foundation to the Pennsylvania Hospital for Mental and Nervous Diseases. Submitted for publication August i6, 1937.