THE SCIENCE AND ART OF PROTEAL THERAPY 151 



leucocytes on one hand and of red corpuscles on the other are 

 critical features of that response. 



That the characteristic response may be kept up for many 

 months is adequately demonstrated in tables above presented. 

 The efficacy of substituting new proteins when the systemic re- 

 sponse has flagged has been amply proved. Whether there are 

 any limits to such substitution, and to what extent it is desir- 

 able to keep up the proteantigen treatment after the seeming 

 recovery of a patient, are questions for the future to decide. It 

 would appear that the study of the blood in a large series of 

 cases must furnish the best clues to an answer. 



AGE AND THE BLOOD COUNT 



In attempting to account for the observed facts of corpuscular 

 variation between childhood and adult life, I have been led to 

 question whether the salient fact that the polynuclear count 

 increases from about 40 to 60 or 70 per cent, of the total leuco- 

 cyte count with the advance in years from adolescence to adult 

 life, may not be merely an evidence of response on the part of 

 the organism to the perpetual bacterial bombardment to which it 

 is subjected. It is familiarly known that bacterial products 

 make up a significant part of the normal faeces ; and, in general, 

 it is understood that we are perpetually assailed by bacteria 

 which have become relatively innocuous merely because of their 

 universal prevalence. 



Obviously, in the natural course of events, such infection must 

 become cumulative; that is to say, we must suppose that on 

 the average the adult individual is more comprehensively affected 

 than the average child. On the hypothesis put forward in an 

 earlier section, it would be the middle products of protein de- 

 compounding chiefly in excess. Conceivably this may be the 

 reason why the polynuclear count goes up, reaching in adult life 

 very frequently a status of approximately double that of the 

 average of childhood and adolescence. 



If this interpretation be correct, the so-called normal leuco- 

 cyte count of adult life might be said to be in itself a mani- 

 festation of abnormality. Such a statement sounds paradoxical, 

 but it may connote an important truth. It is a suggestive fact 

 that in a patient long subjected to Proteal treatment associated 

 with careful attention to hygiene of diet and digestion, it is 

 observed that the polynuclear count very generally comes down 

 as the patient improves, and may even be reduced to the stand- 

 ard of childhood 40 per cent, or thereabouts. In two or three 

 instances where the patient had been for many months under 



