THE SCIENCE AND ART OF PROTEAL THERAPY 187 



the end products of protein metabolism, and in particular with 

 the purin bodies, hypozanthin, zanthin, and uric acid. 



Notwithstanding the fluctuations of medical opinion on the 

 subject, I believe that the uric acid hypothesis is still the most 

 tenable thesis as to the underlying causation of the rheumatoid 

 condition that has been put forward. But whatever the view as 

 to this theory, there is practical unity of belief that the condi- 

 tions under discussion are associated with disturbances of protein 

 metabolism. Whether or not the purin bases are chiefly at fault, 

 there is failure of complete and normal metabolism and elim- 

 ination of the protein intake. The administration of the Pro- 

 teals tends to normalize these processes. Very commonly the 

 blood in these cases shows marked quantitative and qualitative 

 abnormalities of the corpuscles. The Proteals tend to correct 

 these abnormalities. Rarely indeed does the patient fail to im- 

 prove in blood conditions and correspondingly in general clin- 

 ical condition. 



Through such modifica ions, in my belief, the therapeutic ben- 

 efits of the Proteals are to be expected. I have never for a 

 moment entertained the thought that the Proteals are specifics 

 for the rheumatoid conditions. Indeed, I scarcely know what 

 the word specific may mean in medicine except as applied to 

 an agent directed against a particular type of microrganism. If 

 any other use of the word be permissible, it might perhaps be 

 justifiable to speak of the Proteals as specifics for the condi- 

 tion of anaemia, so direct and significant is the response of the 

 blood-forming organs to their stimulus. But anaemia itself is, 

 after all, a condition or symptom rather than a disease; and no 

 wise physician would depend upon mere medication in treating 

 anaemia, without giving thoughtful attention to its underlying 

 causes, and endeavoring to remove these or modify them by 

 eliminating sources of infection, counseling proper diet, and 

 securing the co-operation of proper hygienic measures in general. 



If this is true of the simplest anaemia, it is assuredly doubly 

 true of the complicated anaemias that are associated with the 

 various maladies of disturbed metabolism that are under consid- 

 eration in this book. Above all, this is true about rheumatoid 

 arthritis. This is a malady that makes its encroachments with 

 almost diabolical persistency. It harks back always, I believe, 

 to defective enzymic activities of the intestinal tract. As a rule, 

 it is associated with life-long tendency to constipation. Its ex- 

 istence implies hereditary vulnerability of the joints, combined 

 with inherited or acquired deficiency of action of the organs of 

 digestion and assimilation, probably always associated with 

 what for the patient in question are improprieties of diet. There 

 is usually the history of the habitual ingestion of animal pro- 



