14 PROTEIN THERAPY 



COUNTERIRRITATION 

 (Thermocautery , Seton, Fontanelle, Moxa, Blisters, Rubefacients) 



These, perhaps the most ancient of our methods of intervention in 

 disease processes, purely empirical in origin, represent undoubtedly a 

 form of nonspecific therapy. Crude and barbarous in their applica- 

 tion though some were, there can be little doubt as to their occasional 

 efficacy. Their very antiquity, their widespread use among all peoples 

 and their long continuance in practice more than warrant this as- 

 sumption. And their supposed effects on inflammation the accelera- 

 tion of repair relief from pain hastening of absorption of exudates, 

 might be expected to follow as a result of nonspecific protein therapy 

 as we now understand it. 



Every one of these procedures has as its basis the production of 

 a focus either of necrosis such as produced by the cautery; of sup- 

 puration as with the use of the seton or the fontanelle; or in the 

 milder forms the production of an area of exudation, inflammatory 

 in character, usually serous or seropurulent. The absorption of these 

 pathological exudates by the body must lead to a tissue stimulation 

 perhaps milder in degree and longer in duration similar to that which 

 follows in the wake of our more modern nonspecific therapeutic in- 

 jection. Bloch was one of the first to call attention to the fact that 

 our nonspecific therapy is but part and parcel of this older practice 

 of counterirritation. 



While counterirritation was, as a rule, limited in its applica- 

 tion to localized inflammation and seldom if ever used in acute 

 infectious diseases, we do find that it was recommended in inflamma- 

 tory rheumatism, curiously enough the one disease in which modern 

 nonspecific therapy has perhaps been most consistently successful. 



The Actual Cautery was considered the most effectual agent. We 

 now know that following a burn the resorption of necrotic material 

 from the burned area may result in a typical protein shock reaction, 

 either acute or protracted, depending of course on the degree and the 

 area of injury. Pfeiffer has recently studied in detail the flooding 

 of the organism with proteolytic enzymes following both burns and 

 evitable infection of such issues. 



The Seton, the Fontanelle, and Moxa were all methods designed to 

 produce a superficial suppuration over a longer period of time. Not 

 only were necrotic tissue products being absorbed from such foci, but 

 a heterovaccination carried out at the same time because of the in- 

 evitable infection of such tissues. 



The milder methods produced merely local irritation of the skin 

 either with vesication or hyperemia; absorption of a slight inflam- 

 matory exudate might take place from both. In all of these pro- 



