WILLIAM F. PETERSEN 1087 



the body to the disease— an ergotropie— and take their place with iodides, with 

 arsenic, and with phosphorus. The term "protein therapy" must be enlarged to in- 

 clude all the non-specific biological procedures in contradistinction to methods of 

 therapy based on strictly specific concepts. 



The establishment of the etiological epoch in the seventies of the last century 

 brought with it an utter disregard of the reaction of the infected host. The simple 

 equation, bacteria-f host = disease, sufficed. But finally an impasse was reached; cer- 

 tain facts could no longer be ignored. There were dififerences in susceptibility; and 

 among the susceptible there were differences in resistance, differences that could not 

 be explained on an immunological basis. 



Even during the triumphant bacteriological era competent observers called atten- 

 tion to certain non-specific phenomena— Buchner, Pfeiffer, Rumpf, Matthes, Lander- 

 er, might be mentioned— but clinical application never followed these random obser- 

 vations. With 1914 came a sudden change. A veritable avalanche of clinical reports 

 appeared. Not only was typhoid fever terminated abruptly by intravenous vaccine 

 injection, puerperal fever by coli vaccine, erysipelas and arthritis by milk injections, 

 paresis by tuberculin, skin diseases by autohemotherapy, but even diphtheria was 

 cured by normal instead of antitoxic horse serum. 



Whatever may have been the clinical basis for this intense interest, psycho- 

 logically it probably did represent a protest against the all- too-narrow view of the 

 immunologist concerning the nature of recovery from disease. Specificity and specific 

 antibodies obviously play a role in recovery; quite as obviously they are not the sole 

 factors concerned. 



Today we seek the solution in biochemical and biophysical alterations. Recent 

 advances have made available methods that were closed to the earlier immunologists. 

 Even now there is danger that the pendulum will swing too far in the other direction. 

 We speak now of "colloidoclysis," of "colloidal instability," of "autonomic unbal- 

 ance," of "hormone disfunction," and of "bio-polar reactions" as once we spoke of 

 the opsonins, agglutinins, and Abwehrfermente. 



Non-specific treatment of paresis, of iritis, and of chronic infections (other than 

 tuberculosis) has become an established procedure, varying in methods and agents 

 and application, it is true, but frequently of great benefit to the patient. Even diseases 

 such as purpura, rickets, asthma, diabetes, and ulcer are influenced by non-specific 

 changes in the organism. For these reasons it may be proper to examine the informa- 

 tion that has become available concerning the reaction and the underlying mechanism. 



GENERAL THEORIES 



In general we may discern three theoretical lines of explanation for the therapeutic 

 effect : 



First, the assumption that a general stimulation of the tissue cells results (plasma 

 activation of Weichardt)' or, if not a general stimulation, then a stimulation of 

 certain cell groups or organs. Thus (a) preformed antibodies may be released or (b) 

 enzymes mobilized, (c) the polymorphonuclear leukocytes may be changed or (d) the 

 reticulo-endothelium stimulated. 



' Weichardt, W.: Miinch. med. Wchr., 67, 91. 1920; ibid., 72, 650. 1925. 



