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ELFSTROM'S "PREHISTORIC" (BEFORE RAVAUT 13H1) USE OF SUBCUTANEOUS AUTOBLOOD (1898H1)

Although the Gilbert methodology was well known by the late 1890s, Carl E. Elfstrom of Brooklyn U.S.A. reportedly did not base his work on Gilbert, but rather in 1898 [1898H1] described how his "mind's eye" conceived of autogenous blood therapy. His method was based on the work of G. & F. Klemperer in 1891, who had "succeeded in conferring immunity upon susceptible animals by inoculating them with filtered cultures of the micrococcus" [pneumoniae crouposa] and found that the potency of the filtrates was increased upon heating (40-42 degrees C for 3-4 days or 60 degrees for 1-2 hours). Elfstrom reasoned that if heating might increase the potency of such filtrates, it might also increase the potency of those elements in the blood that confer immunity: "Does not lobar pneumonia, for instance, with its high temperature, limited time, and crisis, prove the plausibility of such a therory? ... Let some blood be taken from a patient suffering from an infectious disease, such as pneumonia, typhoid fever, diptheria, yellow fever, etc., and heated to a temperature of 60 degrees for two hours, and let it be injected subcutaneously into the patient's body. Why, then, should not the immunity hereby be hastened, that is, the duration of the disease shortened?"

AUTOBLOOD FOR CROUPOUS PNEUMONIA, SUBCUTANEOUS - 1898H1
Elfstrom's first reported case, croupous pneumonia complicated by otitis media, in a 30 year old woman: "Temperature 104 to 105 Deg. F; great prostration. I saw the patient the 7th day of the disease, and applied 2 leaches on the breast. When well-filled they were taken off, and by means of salt the blood was squeezed in a clean tumbler and mixed with a salt solution (9-tenths %) in a proportion of 1 to 6. This mixture was put in a test tube, which was finally placed in water and heated to 60 degrees for 2 hours. The blood was now subcutaneously injected into the breast of the patient. ... within a week the patient was restored to health."
A second case involved a 3-1/2 year old child with "crouous pneumonia unilateral, as a sequela of scarlatina and complicated by meningitis. High temperature. Comatose condition and twitching of both arms." Here Elfstrom withdrew venous blood, defibrinated it, mixed it with salt solution, heated it, and reinjected it. The child remained comatose and died 2 days later.
In two subsequent cases, both children, but neither comatose, Elfstrom used one leech on the arm and both patients recovered. "Not seeing any advantage in taking blood directly from a vein, I now always employ leeches ... ." Elfstrom had also decided to use only one leech in each case, and that the temperature of heat be 176 degrees F. In pneumonia he had only used one injection each, but in other diseases, e.g. phtisis, he had not achieved "very brilliant" results even with repeated injections at intervals of 5-14 days, and had decided to repeat injections each 3rd day.

In subsequent reports, Elfstrom and Grafstrom restricted his comment to croupous pneumonia, in all reporting on 9 cases, of which 2 died. "As these latter already before the injections gave unmistakable signs of meningitis ... the percentage of cure ... up to the present, has been 100 percent."