METABOLISM IN FEVER AND CERTAIN INFECTIONS 145 



into the realms of immunology. Some of the experimental work, however, 

 has been along metabolic lines and has supplemented the findings in the 

 ordinary infectious diseases. The matter is not unimportant from a 

 clinical standpoint since the intravenous administration of vaccines is 

 now used in many clinics. 



The history of the early clinical applications has been well reviewed 

 by Jobling and Peterson (6), who describe the pioneer work of Matthes(a), 

 Fraenkel and others. Miller and Lusk(a) (&), Gay and Chickering, Cecil, 



o> 



at 



CM 



0> 



2 



m 



39 

 38' 



ISO 

 CALS 



100 

 50 



CHILL 



INDltCT UAL. 



P1BEQT-QA. 



PER HOUR 



HLAI LLIMJ 



.70 



AV.BODY TEMP. 



VAPORIZATION CAL. 



~ "BASEL"? 



Fig. 27. Calorimeter observation of chill following the intravenous injection of 

 25 million killed typhoid bacilli. The subject, a young man of 19 years, suffered 

 from gonorrheal arthritis. The injection was made at 10:50 A.M. and the observa- 

 tion s'tarted at 11:29 A.M. Note the similarity between this chart and the ones 

 showing the malarial paroxysms. 



Snyder and numerous other clinicians have tried foreign proteins, pro- 

 teoses, etc., intravenously in many diseases. The results have been some- 

 what encouraging, especially in chronic arthritis, but at the present time 

 the method is not in great vogue. Accidents have occurred, but those who 

 are experienced in its use say that it is harmless if proper precautions are 

 observed. 



When a patient is given intravenously a small dose of foreign protein, 

 say 20 to 50 million killed typhoid bacilli, the clinical phenomena are 

 striking. After a latent period of a few minutes the patient is suddenly 

 seized with a violent chill resembling in every respect a malarial paroxysm. 



