THE NONSPECIFIC AGENTS 27 



chill, sweating and fever and would at the same time give an equally 

 satisfactory therapeutic result. 



There is little doubt that from the clinical standpoints such an 

 agent would be a very desirable one, and it is an idea that should 

 be kept in mind. But we are confronted with the probability that, as 

 will be pointed out in the chapter on The Focal Reaction, the posi- 

 tive phase or mechanism of recovery after nonspecific injections is 

 a function, or at least very closely related to the degree of the 

 negative phase or the intensification of the disease process that is 

 clinically manifest in the reaction of the patient. Just as in local 

 foci of disease a marked augmentation of the inflammation, both 

 after specific vaccine injections (as after the injection of "Arthigon" 

 Schultz found that gonorrheal lesions healed best after severe 

 reactions) or nonspecific injections is followed as a rule by clinical 

 improvement, so in the general infections a relatively severe re- 

 action is more frequently followed by an abortive recovery 

 than when the reaction is very mild or absent. I cannot too strongly 

 emphasize, however, that the utmost care and judgment must be ex- 

 ercised and a considerable degree of experience must be gained in 

 the treatment of such diseases as arthritis or of local inflammations 

 before the attempt is made to treat general infections, unless the 

 physician wishes to court disaster. 



The entire question of dosage and of the proper reaction is still 

 an open one. I believe that the method of Holler is a safe one and 

 one that can be recommended. Holler injected his cases of in- 

 fectious diseases with a daily dose of deutero-albumose that was just 

 sufficient to elicit a mild reaction. In some diseases he administered 

 two doses daily. This method is certainly much safer than the ad- 

 ministration of a single huge dose which may be more than the patient 

 can bear. 



v. Biedl has made use of Histamin, using 0.5 mg. for intravenous 

 injections. The results were not particularly satisfactory, nor were 

 they much better when Witte Peptone was employed. 



On the other hand both Nolf and Gow have used Witte Peptone 

 with evident success. Gow employs a 10% solution. This is made 

 up by dissolving 10 gm. of the dry peptone in about 5 c.c. of hot 

 freshly distilled water and bringing the volume up to 100 c.c. Of 

 this from 8 to 10 c.c. are slowly injected intravenously. 



The effect of the intravenous injection of various split products 

 of proteins both from the physiological as well as the pharmacological 

 standpoint has been intensively studied both in this country and in 

 Europe and the literature is so well known and readily available that 

 it will not be necessary to enter into it here. The effect of the intra- 

 venous injection of Histamin has been more recently studied by 

 Dale and Laidlow. 



