168 THE PROTEOMORPHIC THEORY AND THE NEW MEDICINE 



types of toxaemias associated with secondary anaemias and neuras- 

 thenia. 



In cases of the latter type a maximum dose of 5 to 8 minims 

 usually suffices, and often results of the most conspicuous and 

 well-defined character may be attained with a dosage of only 4 

 or 5 minims. 



In general, my present tendency is to use small doses, and if 

 necessary give them more frequently, rather than to force the 

 dosage to heroic proportions. With the new proteals there is no 

 objection to frequent administration, as the giving of the hypo- 

 dermic is practically painless. 



Probably the most satisfactory method of treatment, whether 

 of simple toxaemias or malignant ones, is to administer a given 

 Proteal in gradually increasing doses until the maximum dose 

 considered desirable in a given case is reached that is to say, a 

 dose that produces a satisfactory clinical progress and character- 

 istic modifications of the blood count; to hold to this maximum 

 dose for a week or ten days ; and then to shift to another pro- 

 teal, beginning with a dose of three or four minims and working 

 up the scale as before. It should be remembered that each pro- 

 tein elicits its own response, and that a patient relatively im- 

 munized to, let us say, mustard seed or rape seed proteins may 

 react vigorously to the protein of alfalfa. The rule is, in begin- 

 ning with a new protein, to start with a minimum dose, no mat- 

 ter how thoroughly accustomed the patient is to the administra- 

 tion of other proteins. 



Similarly if the patient has discontinued the Proteal treatment 

 for a considerable period, and then begins it again, even with 

 the same Proteal, it is well to start in with a small dose, but 

 in this case the dosage may be increased much more rapidly 

 than with a new patient. 



It is my routine practice to administer the Proteals by fairly 

 deep subcutaneous hypodermic injection into the back of the 

 upper arm. Intravenous injection has sometimes been employed, 

 but this produces a severe anaphylactic reaction the desirability 

 of which is doubtful unless in very obstinate and intractable 

 cases. I do not advocate or practice the method of heroic dosage, 

 with emphatic anaphylactic reaction, that a few physicians who 

 in recent months have advocated non-specific protein therapy with 

 the use of vaccines appear to have employed. My own experi- 

 ence, based on study of a far larger number of cases than have 

 elsewhere been treated with non-specific proteins in the entire 

 world, leads me to conclude that the milder method of admin- 

 istration is equally efficacious in the end, while being devoid of 

 unpleasant features. 



It is obvious that patients suffering from a simple anaemia 



