26 PROTEIN THERAPY 



fibrin were much more toxic than the others. Those from gelatin 

 followed next in the severity of the reaction while those derived from 

 wheat, horn, silk, etc., gave little or no reaction. 



From the studies of Baehr and Pick it seems most probable that 

 the toxicity of protein preparations such as these depends to a large 

 degree on the presence or absence of the cyclic or ring compounds 

 in the protein molecule. Perhaps, too, the size of the colloidal aggre- 

 gate is of importance in determining the reaction after intravenous in- 

 jection. 



The dosage of the Deutero-albumoses and of the other primary 

 and secondary proteoses so far used, has varied. In our own work 

 we have used from % to 2 c.c. of a 2% solution of secondary proteose. 

 Liidke first used about 2 c.c. of a 2% solution; recently he has in- 

 jected from 1 to 2 c.c. of a 10% solution; Holler used 1 c.c. of a 10% 

 solution. 



Jobling as well as the writer have been under the impression that 

 small doses repeated at frequent intervals offer the best mode of 

 administration. Jobling in his Harvey Lecture recommends begin- 

 ning with a dose of 0.25 c.c. of a 1% solution and determining if the 

 patient reacts with much temperature. If there is no general reaction 

 from this dose a somewhat larger dose can be selected for injection 

 the following day. This is particularly advisable in the more toxic 

 forms of infectious diseases; in arthritis, on the other hand, it may 

 be better to give a relatively large dose (after its reactivity is known) 

 at the beginning and induce a sharp reaction. The reaction follow- 

 ing the injection depends not only on the dose but on the type of dis- 

 ease from which the patient is suffering, just as with milk injections. 

 (Schmidt.) 



The patient does not become sensitized to proteose injections; 

 rather a degree of tolerance is established, so that following or re- 

 peated injections do not give an equal response on the part of the 

 patient. 



In animal experimentation there is some evidence that sensitiza- 

 tion, at least to the higher proteoses, can be established. In the hu- 

 man there has been no evidence of this effect, at least as far as 

 can be determined from the clinical reaction that follows after repeated 

 injections. 



It is very doubtful to my mind if a therapeutic effect can be 

 achieved unless a general reaction is brought about in the patient. 

 Nolf emphasizes that shock should be avoided "when one employs 

 proteosotherapy to cure a patient of an infectious disease one should 

 avoid shock at least the violent shock which I have described. But 

 it seems to be an advantage to produce a mild reaction which I have 

 called the 'peptone effect' in contrast to 'peptone shock.' " 



Efforts of many workers have been directed in producing some 

 agent that would not produce a severe reaction that is, the nausea, 



