I096 NON-SPECIFIC PROTEIN THERAPY 



status of the periphery and consequently a leukopenia' and a chill.^ A rise in temperature 

 takes place because of the relative fixation of the autonomic apparatus (internal parasym- 

 pathetic, external sympathetic). During this time the glands of internal secretion play a 

 role, probably by the liberation of epinephrin (Cannon) . The epinephrin may intensify the 

 contraction of the peripheral vessels but causes no contraction of the splanchnic region be- 

 cause here, in stimulated tissue, the reaction is paradoxical. 



When the parasympathetic status of the splanchnic region has been established the 

 secretory organs are stimulated.^ Thus there is an increased bile flow from the liver, 

 perhaps gall-bladder contraction. •< The pancreas secretes insulin as well as its external 

 secretion.5 The villi of the intestine exude a thin milky fluid.^ The stomach secretes an acid 

 gastric juice and dilates, i.e., assumes a status similar to that after food ingestion (Petersen 

 and Muller).7 



There is a transient alkalosis (Lukacs), and then the phase of acidosis is initiated. 

 Lymph flow is augmented, the capillaries become more permeable, the calcium-potassium 

 ratio is diminished. All of these changes are associated with the parasympathetic status of 

 the splanchnic region, and the change in organ activity brings with it alterations in the 

 platelet count,^ in the blood and lymph sugar,"*-*^ in the blood pressure, etc. The periphery 

 is sympathetically oriented, the blood vessels of the skin and muscle contracted, heat loss 

 diminished, glandular activity lessened (Petersen and Miiller). 



Then follows a reversal of the splanchno-peripheral balance, and the splanchnic region 

 becomes sympathetically and the periphery parasympathetically oriented (leukocytosis, 

 heat loss, etc.). The calcium-potassium ratio is increased, an alkalosis is established, activity 

 of the reticulo-endothelium is greatly reduced (Jaffe, in unpublished experiments, finds the 

 time of phagocytosis of oleokoniol before the chill between four and five minutes, during the 

 time of chill under three minutes, and after recovery from seven to fifteen minutes, a condi- 

 tion that is maintained for several days), there is positive nitrogen and water balance, etc. 



The non-specific reaction autonomically is characterized by its distinct diphasic 

 character, which can be resolved into distinct chemical, endocrine, hormone, and 

 nervous components. 



THE REACTION IN TYPHOID FEVER 



Typhoid fever represents an acute infection of peculiar character, peculiar be- 

 cause of the localization in the splanchnic lymphatic apparatus. As I have mentioned, 



'Muller, E. F.: loc. cit. 



2 Petersen, W. F., and Miiller, E. F.: Arch. Int. Med. (in press). 



3 Weichardt, W., and Scholz, G.: loc. cit. 



•• Miiller, E. F., Petersen, W. F., and Kast, A. (in press). 



5 La Barre, J.: Compt. rend, de la Soc. de Biol., 96, 149. Paris, 1927. 



* King, C. E., Arnold, L., and Church, J. G.: Amer. Jour. Physiol., 61, 80. 1922. 

 7 Miiller, E. F., and Petersen, W. F.: Miinch. med. Wchr., 74, 531 and 58S. 1927. 



* Vorschutz, J.: Pjhtgits Archiv., 189, 4. 1921. » Stahl, R.: Kl. Wchr., i, 2132 1922. 

 '"Gruenthal, R. M., and Brown, G. M.: loc. cit. 



" Lowy, J.: Berl. kl. Wchr., 54, 989. 1917; and Dent. .Xrch. kl. Med., 120, 131. 1916. 



" Lohr, W. and H.: Zeit. f. d. ges. e.\p. Med., 31, 19. 1923. 



'3 Stern, W., and Wozak, J.: Monalschr. f. Kinderheilktinde, 28, 490. 1924. 



'* Menten, M. L.: Jour. Infect. Dis., 38, 354. 1926. "s Petersen and Muller (in press). 



'''Fischer, A., and Weiss, H.: Biochem. Zeit., 159, 141. 1925. 



