36 PROTEIN THERAPY 



proportions of bacteria were so uniform, he used a polyvalent heterogeneous 

 preparation in some cases. 



Muck's Antigen. Much has recently described a vaccine which 

 he terms "Immunvollvaccine' for intramuscular injection, which he 

 has used in the treatment of influenza. It is prepared from a num- 

 ber of nonspecific antigens: (a) Reactive proteins, the metabolic 

 products of several nonpathogenic bacteria, (b) a lipoid mixture from 

 bile, and (c) a fat mixture of animal derivation. The theory under- 

 lying such a mixture is that of partial antigens which he has developed 

 in tuberculosis. 



BACTERIAL EXTRACTS AND RELATED SUBSTANCES 



The use of bacterial extracts and of bacterial growth products 

 to produce a nonspecific temperature increase is not a recent inno- 

 vation. 



Tuberculins have been used for this purpose for some time, es- 

 pecially in the treatment of paresis, as introduced by v. Jauregg. For 

 this purpose a relatively large dose is used, beginning with 0.01 mg. 

 and increasing rapidly until as much as 0.5 mg. is injected. The 

 temperature reaction is a prolonged one; usually a leukocytosis is 

 produced. It offers no particular advantages over milk injections 

 which produce practically the same results. 



Kaiser has used Tebelon, the isobutyl ester of oleic acid (intro- 

 duced by Stoeltzner) , in a number of surgical conditions. Like other 

 nonspecific substances it acts as a pyrogenic agent even in nontuber- 

 culous diseases. 



Typhin. Biedl in 1915 noted that the nonspecific reaction could 

 be elicited with histamin, the toxicity of which had been previously 

 studied, v. Groer made use of this knowledge in preparing a mix- 

 ture of nucleoprotein and histamin from typhoid bacilli which he 

 called "typhin" to be used in place of whole bacilli for intravenous 

 injections. The chief advantage of the preparation lay in the fact 

 that with such a substance the dosage might be standardized and 

 the reaction gauged. With this "typhin" v. Groer treated 23 cases 

 of typhoid, of whom 18 made a prompt recovery and 5 died. In 

 the case of a typhoid patient that recovered by crisis after the in- 

 jection and died a few days later from an intercurrent condition, v. 

 Groer observed at the autopsy that the ulceration of the bowel had 

 practically healed and that the spleen was small (v. Wiesner has 

 recorded similar observations). 



It is interesting to note that v. Groer found no increase of anti- 

 bodies in the serum of patients after the injection despite the fact 

 that such patients made an excellent and prompt recovery after the 

 injections. 



