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 IMontrMl 
 
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N 
 
 
 
 ] dWv\S I^SM \aJ • 
 
 Reprinted from the New York Medical Journal 
 for November 28, 1896. 
 
 A NOTE UPON 
 
 SERUM DIAGNOSIS BY MEANS OF DRIED BLOOD 
 
 SAMPLES IN (EXPERIMENTAL) CHOLERA. 
 
 By WYATT JOHNSTON, M. D., and E. W. HAMMOND, 
 
 MONTREAL. 
 
 (From the Molson Faihological Laboratory, McGHll University, ) 
 
 The announcement made by Achard and Bensaude 
 {La Presse medicate, September 26, 1896; abstract in 
 New York Medical Journal, November 7, 1896) that 
 they had successfully employed serum diagnosis in all 
 of eleven cases of cholera, has led us to publish briefly 
 the result of some experiments we have been making 
 to see if drops of dried cholera blood form a suitable ma- 
 teria IT obtaining and testing the serum reaction. Not 
 havi -^ the blood of cholera patients at our disposal, we 
 experimented on rapidly immunized guinea-pigs. 
 
 We find that when the blood serum of an animal 
 gives a good reaction in the fresh state the reaction 
 may also be obtained by moistening a drop of the dried 
 blood with water and mixing it with an actively motile 
 cholera culture. 
 
 The cholera culture employed was one isolated by 
 Dunham in 1893/ from a case in New York and trans- 
 
 COPTRIQHT, 1896, BY D. APPLETON AND COMPANY. 
 
2 
 
 SERUM DIAGNOSIS IN CHOLERA. 
 
 mittcd to the laboratory in 1893 by Professor Welch, of 
 Johns Hopkins. This was brought up to a high degree 
 of virulence by passing it through a series of guinea- 
 pigs until intraperitoneal injection killed ip ten hours, 
 and subcutaneous injection in twenty hours. 
 
 From a tenth to half a loopful of sterilized sus- 
 l)ensions of a twenty-hour growth in agar was injected 
 beneath the skin or into the peritonaeum of guinea- 
 pigs, and was followed by prompt loss of weight. The 
 larger doses usually produced promptly the character- 
 istic blood reaction in the course of a few days, varying 
 in intensity with the different animals. 
 
 The reaction was found well developed in one case 
 within three days and a half after the dose. Here 
 the animal died from a secondary infection. The dried 
 blood, first examined two days after the animal's death, 
 gave the reaction to perfection, extensive clumping tak- 
 ing place in the momentary interval between mixing 
 the drop of dried-blood solution with the culture and 
 bringing it under the microscope. Positive results were 
 obtained in the cases of two other guinea-pigs inocu- 
 lated on the same day. Check examinations of healthy 
 animals and of these inoculated with very minute doses 
 gave negative results. 
 
 From this it appears that the sending of samples of 
 dried blood is likely to suffice for the serum test. We 
 hope before long to receive samples of dried cholera 
 blood sent us under conditions which will be such 
 as to give the method a practical test. 
 
 The fact that Achard and Bensaude found the reac- 
 tion present even as early as the first day (in non-fatal 
 cases) should make it invaluable in the diagnosis of 
 cholera. 
 
SERUM DIAGNOSIS IN CHOLERA. 
 
 8 
 
 We have been surprised to find the ease with which 
 the typical serum reaction, though not complete im- 
 munity, could be induced in animals by even a single 
 dose of typhoid and cholera culture. 
 
 A preliminary protective dose is not strictly neces- 
 sary, but it guards against loss of the animals by an 
 accidental overdose. 
 
 We have followed Pfeiffer's recommendation to 
 wait until the loss of weight of the animal is made up 
 before repeating the dose.