WILLIAM F. PETERSEN 1093 



changes in capillary permeability following protein therapy have been studied by Muller/ 

 Starkenstein,^ Luithlen,^ Petersen,^ and many others.^-^ An increase in permeability follows 

 the primary reaction, but this increase is largely confined to the splanchnic region. Later 

 there is a reversal to impermeability. 



The reticulo-endothelium becomes more active (phagocytosis) and later shows greatly 

 lessened activity. This change is true not only in relation to formed particles and colloids, 

 but seems to hold true for the passage of water. To Saxl' in particular we are indebted for 

 much information in this connection. 



The Nervous System. — Kling'" in 191 2 demonstrated the increased irritability of the 

 peripheral nervous system during the course of sensitization. Gamper and Chiari" and 

 Weichardt'^ have confirmed this. PoUitzer and Stolz have studied the effect on the brain 

 centers" for respiration and temperature regulation. Perhaps of far greater importance is 

 the change that takes place in the autonomic nervous apparatus, a subject that has been 

 reviewed by Freund,'-" Lukacs,'^ Muller, Myers, and Petersen'^, and Muller and Petersen. '? 

 Freund and Gottlieb'^ determined that the autonomic apparatus became more susceptible to 

 pilocarpine as well as to epinephrin,'*-^' but the ultimate effect seems to be a distinct increase 

 toward the sympathetic side.^^ I shall discuss the subject in greater detail. 



PHARMACOLOGICAL ASPECTS 



The pharmacological aspects underlying "protein therapy" have been treated in 

 recent years by H. H. Meyer,^^ Freund,'^ Weichardt,'^ and in this country Hanzhk'^ 

 has added much to our knowledge. Meyer emphasizes a number of principles 



' Miiller, quoted by Ebbecke, U.: Dent. med. Wchr., 50, 131. 1924. 

 ^ Starkenstein, E.: Miinch. med. Wchr., 66, 205. 1919. 



3 Luithlen, P.: Med. KL, 2, 1713. 1913. 



4 Petersen, W. F.: Protein Therapy. Macmillan, 1922; Wien. kl. Wchr., 37, 233-56. 1924. 

 s Seiffert: Berl. kl. Wchr., 58, 873. 1926. 



^Siegmund, H.: Kl. Wchr., i, 2566. 1922. 



' Siegert, quoted by DoUken, Berl. kl. Wchr., 56, 226 and 277. 1918. 



^Embden, G., and Lange, H.: A7. Wchr., 3, 129. 1924. « Saxl, P.: loc. oil. 



" Kling, C. A.: Zeitschr.f. Imm., 13, 43. 1912. 



"Gamper, E., and Chiari, O.: Dent. Zeitschr.f. Chirg., 172, 161. 1922. 



" Weichardt, W.: Technik soivie serologische Studien auf dem Ge'u'el der exp. Therapie. Stuttgart: 

 Enke, 1906. 



'3 Pollitzer, H., and Stolz, E.: Wien. Arch. inn. Med., 12, 169. 1926. 



'4 Freund, H.: Dent. med. Wchr., 52, 2187. 1926. 



's Lukacs, Jos.: Wien. Kl. Wchr., 39, 885. 1926. 



i« Muller, E. F., Myers, C. N., and Petersen, W. F.: Jour. Amer. Med. Assoc, 88, 1128. 1927. 



"Muller, E. F., and Petersen, W. F.: A7. Wchr., 5, 53. 1926. 



'8 Freund, H., and Gottlieb: Arch.f. exp. Path, imd Pharni., 91-92, 272. 1922; ibid., 93-94, 92. 

 1922. 



1' Klemperer, G.: Berl. med. Gess, June 16, 1926 (A7. Wchr., 5, 1489. 1926). 



^oFriihlich, A., and Paschkis, K.: Arch.f. e.xp. Path, nnd Pharni., 117, 169. 1926. 



2' Rosenthal, F., and Holzer, P.: Berl. kl. Wchr., 58, 675. 1921. 



" Adler, A., and Blumenberg, E.: Zeitschr.f. kl. Med., 95, 109. 1922. 



^i Meyer, H. H.: PharmakologischeGnindlagender Reizk'cirpertherapie. Wien: Moritz Perles, 1925. 



^4 Freund, H.: loc. cit. ^s Weichardt, W.: loc. cit. 



^^Hanzlik, P. J., Deeds, F., and Tainler, M. L.: Arch. int. Med., 36, 447. 1925. 



