THE ANTIFERMENTS. 95 



can be considerably increased in animal experimentation by a group of well-known pro- 

 teolytic agents, and especially by leucocyte ferment and pancreatic trypsin. To differ- 

 entiate between antileucocyte and antitrypsin ferment in the narrow sense of the word, is 

 impossible. The one "immune serum" (sit venia verbo, if one can speak of immune 

 serum in this sense) neutralizes the other antigen. Clinically a high antitryptic titer of 

 the serum is found in about 90 per cent, of carcinoma patients, and is almost regularly 

 observed in infections with high fevers as typhoid, severe articular rheumatism, sepsis, 

 etc. In pneumonia there is found during the infection a marked change from an exces- 

 sively high to a low titer. In Morbus Basedow (as well as in experimental thyroid feed- 

 ing) it is almost the rule to find a high antitrypsin content, but one must always keep in 

 mind that even few normal individuals show a similar increase. 



The clinical diagnostic import of the antitrypsin titer is slight in comparison with its 

 experimental increase. In accord with the findings in Basedow, and in thyroid feeding 

 it may be considered as an outcome of increased proteid destruction (hyper-produc- 

 tion of proteolytic ferments in the tissues?) Leucocyte ferment has been found of prac- 

 tical use in the treatment of cold abscesses, i.e., in processes where leucocytosis and failure 

 to produce polyneuclear leucocyte ferment is present. On the other hand antitrypsin 

 or antileucocyte ferment or even normal serum is employed to counteract inflammatory 

 processes, i.e., to neutralize the excessive production of the leucocyte ferments, with appa- 

 rent success (Leucoantifermentin, on the market). According to recent findings, the 

 antitrypsin titer of the mother's blood increases markedly during the period of labor, 

 while that of the fetus remains unaltered. 



There are two methods for the antitrypsin determination. The first was 

 devised by Jochmann and Miiller for proving the presence of leucocyte 

 ferment and its antiferment, and then similarly employed by Marcus in the 

 study of pancreatic ferments. Its principle depends upon the digestive 

 action of proteolytic ferments upon serum albumin. When a drop of 

 trypsin is placed upon a Loffler's serum plate, after a little while, a clear 

 spot appears where the trypsin was brought into contact with the plate. 

 If to this trypsin, an amount of serum is previously added, which fully 

 neutralizes the digestive action, no clear zone appears upon Loffler's plate. 



The details of this procedure are as follows: The ferment solution consists of o. i gm. 

 trypsin, well shaken with 5 c.c. of undiluted glycerin and 5 c.c. of distilled water, then left 

 in an incubator for a half hour at 55 C., then again shaken and filtered. 



The serum is mixed in small test tubes or upon a glass slide with varying amounts of 

 the trypsin; thus i loopful of serum is mixed with 1/2, i, 2, 3, 4, etc., up to 20 loopfuls of 

 the trypsin solution and of each of these mixtures one loopful is placed upon Loffler's 

 plate. (Ox serum plate should be three days old). The plates are then placed into the 

 incubator for twenty-one hours at 55 C. The presence or absence of the clear zones 

 determines the quantities of ferment which respectively have not or have been neutralized 

 by the one drop of serum (e.g., i : 6 means that in the mixture of 6 loopfuls of trypsin and i 

 loopful of the serum for examination the digestive power of the trypsin was still interfered 

 with). 



The inequality in the strength of the Loffler plates, their variability in the degree of 

 alkalinity, the measurement by loopfuls, all, might prove to be sources of error which 

 may greatly influence the results. Thus the latter can only be taken as approximate, 

 relative values. 



