510 PARENTERAL NUTRITION 



As to the question of the practical applicability of paren- 

 teral introduction of protein, it should be understood that the 

 procedure is anything but a harmless expedient. 76 It would 

 not necessarily mean very much that after parenteral intro- 

 duction of protein an unusual amount of ammonia was noted 

 in the urine and a percentage increase in the pur in figures. 77 

 The observation of an redematous swelling of the mammary 

 glands after casein injection might be related with a specific 

 sensitivity of the latter toward casein. 78 But we cannot but 

 be startled by statements like those of Friedemann and 

 Isaak, 79 to the effect that intravenous introduction of serum 

 albumen is not followed by toxic effects in fasting dogs, but 

 in well fed animals in nitrogen equilibrium usually induces 

 symptoms which end in death. The many experiences with 

 anaphylaxis, and the danger of repetition of parenteral in- 

 troduction of protein brought to light in recent years (the 

 " serum diseases" from the therapeutic use of diphtheria 

 antitoxin serum, etc., undoubtedly belong here in part) must 

 necessarily very much depress any hope of making paren- 

 teral protein feeding ever of any great practical value in 

 medicine. E. Heilner 80 regards it as probable that the 

 phenomena of " anaphylaxis " are due, not so much to the 

 production of abnormal toxic intermediate products of pro- 

 tein metabolism, as to the relative resistance of substances 

 which under other circumstances are rapidly elaborated. 



Possibly, however, a greater practical importance may 

 attach to the parenteral introduction of the products of 

 hydrolytic cleavage of protein than to the parenteral ad- 



78 Cf. the careful investigations in TangFs Laboratory by P. Hari, C. Rud6 

 and S. Cserna, and L. Ornstein (Biochem. Zeitschr., 44, 1, 40, 94, 140, 1912) 

 upon the influence of intravenous and intraperitoneal infusion of blood, and 

 of subcutaneous feeding with bloodserum-glucose mixtures. 



77 S. v. Somogyi (Physiol. Instit., Budapesth), Zeitschr. f. physiol. Chem., 

 71, 125, 1911. 



78 P. Rona and L. Michaelis, 1. c. 



79 U. Friedemann and S. Isaak, 1. c. 



80 E. Heilner (Physiol. Instit., Munich) Zeitschr. f. Biol., 58, 333, 1912; cf. 

 therein Literature. 



