THE NONSPECIFIC AGENTS 23 



been reported and but few cases of shock following the repeated in- j 

 jections (Sachs, Oppenheim, Lubliner, van Randenborgh). The last \ 

 observer is of the opinion that some of the milk preparations (caseosan, 

 etc.) are more apt to be followed by shock symptoms than are milk 

 injections. 



Where shock symptoms have occurred it is by no means ex- 

 cluded that part of the injection may not have accidentally reached a 

 vein. Great care should always be exercised that the injections are 

 intramuscular. 



The fact that there is relatively very little sensitization of the 

 patient following milk injections has been variously accounted for. 

 The human organism is not, as a matter of fact, very susceptible 

 to anaphylactic shock under any circumstances, and Salus has sug- 

 gested that in the case of the milk injections the fact that the milk 

 has been boiled would tend to dedifferentiate it and diminish the ten- 

 dency to sensitization. 



Slawik recommends the use of human milk in place of cow's milk, 

 especially in the treatment of infants. He found that both wet-nurses 

 and atreptic infants were refractory to such injections, there being 

 absolutely no temperature response. According to Epstein adults re- 

 act to human milk with an increase in temperature, etc., just as they 

 do to cow's milk. 



Local injections of milk have been used by Weiss and others in the 

 treatment of buboes and local inflammatory processes. While a 

 general reaction results, there is a decided local effect similar to that 

 noted when serum and physiological salt solution are injected locally. 

 (Vide.) 



For intravenous injection fat- free milk has been prepared by 

 thoroughly extracting the milk with fat solvents and later carefully 

 evaporating the solvent that may, after gross separation, still be present 

 in the milk. 



Casein (Aolan, Caseosan). Lindig and Miiller both proceeded to | 

 refine this so-called "milk therapy" by using purified casein in its 

 place. This has the advantage of being a chemically constant product, 

 free from bacteria, for which one might presumably determine a 

 standard dosage. 



Lindig has used a 5% solution. This is prepared by adding 5 

 grams of purified casein to a N-10 solution of sodium bicarbonate 

 (20 c.c.), shaking and agitating the same until the casein is all dis- 

 solved and then adding 80 c.c. of distilled water. Of this solution from 

 % to 1 c.c. is given intravenously. Injections are followed as a rule 

 by a chill in about 1 hour, some headache and a moderate increase in 

 temperature about 3 F. 



Miiller has used a similar casein preparation which has recently 

 been placed on the European market under the trade name of Aolan. 

 While Lindig considers that the casein represents the active substance 



