POLYSACCHARIDE-SPLITTING ENZYMES 315 



which extension of the pneumonic process was occurring at the time of 

 treatment, the spreading promptly ceased following the initial injection 

 of enzyme. Although the density of the area of consolidation might at 

 first appear greater than before treatment, extension did not occur and 

 resolution of the lesion soon began. This limitation of spread of the 

 pneumonia was not infrequently noted in the severe cases before the 

 bacteria were completely eliminated from the blood stream. A compari- 

 son of the ultimate degree of pulmonary involvement in the treated and 

 untreated cases reveals the fact that it was less, in general, in the for- 

 mer series. While in the treated cases the extension was apparently lim- 

 ited early, in the untreated animals extension of the pneumonia pro- 

 gressed, frequently with fatal results. 



That the administration of enzyme promoted sterilization of the 

 blood stream seems certain. In the milder cases this occurred quite rap- 

 idly. In animals in which the higher degrees of septicemia were present, 

 there was rarely an increase, more regularly a prompt decrease in the 

 number of pneumococci in the blood following the administration of en- 

 zyme. Even in cases which eventually terminated fatally, or in which 

 extreme septicemia occurred early in the disease, cultures of the blood 

 showed a marked reduction in the number of bacteria within 4 to 5 

 hours after the first treatment. 



Simultaneously with limitation of the pneumonia, beginning resolu- 

 tion, and elimination of septicemia, a fall in temperature usually oc- 

 curred. In fact, there was a tendency for the fever to subside concur- 

 rently with the cessation of pneumonic spread, even though septicemia 

 still persisted. Although a marked leukopenia was comparatively fre- 

 quent at the time treatment was begun, the number of leukocytes rose 

 with the beginning of recovery. 



In fatal untreated cases with septicemia, a high incidence of positive 

 cultures was obtained from pleural or pericardial fluids at autopsy. In 

 many instances frank empyema or pericarditis was present. In the 

 treated cases with severe infections which resulted fatally, the incidence 

 of these complications was also high. In recovered animals of the 

 treated series, therefore, a frequency of suppurative complications equal 

 to that of the untreated animals might be expected. The fact that the 

 treated animals which survived recovered without suppurative sequelae 

 suggests that enzyme therapy either prevented the development of em- 

 pyema and pericarditis or was therapeutically effective even in the pres- 

 ence of these complications. 



As previously stated, many technical difficulties have been encoun- 



