CHAPTER III 

 THE NONSPECIFIC REACTION 



The intravenous injection of bacterial suspensions such as typhoid 

 bacilli, colon bacilli or staphylococci, their intramuscular injection in 

 larger dosage, the intravenous injection of bacterial or other protein 

 split products such as proteoses ; of colloidal metals ; of distilled water 

 or hypertonic salt solution ; of various serums and antitoxins ; the intra- 

 muscular injection of milk or casein, the subcutaneous injection of 

 nucleic acid or sodium nucleate, the production of sterile abscesses 

 with minute injections of turpentine, are all followed by a reaction 

 that varies from a mere stimulation of leukocytes, to mild febrile 

 reactions, and to extreme shock pictures associated with profound 

 vasomotor paralyses. The reaction varies with the substance used, 

 its method of application and absorption, and its dosage; with the 

 type of infection with which we are dealing; with the number of 

 previous injections; with the physical condition of the patient; with 

 the duration of the disease from which the patient is suffering; with 

 the temperature of the patient at the time of the injection and other 

 individual factors. 



We do not yet know how much of the reaction that we elicit 

 is necessary to bring about the therapeutic effect that we seek to 

 achieve. We know that some substances provoke fewer symptoms 

 that are uncomfortable to the patient and yet seem quite as efficacious 

 in their result. On the other hand some substances are followed 

 with only a mild reaction and seem much less effective than the 

 methods that are seemingly more drastic in their action and much 

 more unpleasant for the patient. 



Certain of the agents always give a reaction in both normal in- 

 dividuals and persons ill from disease and give a reaction in a rela- 

 tively short period of time after the injection. Typhoid vaccine 

 belongs in this category. The colon bacillus more often gives a de- 

 layed reaction, while some of the protein split products such as the 

 albumoses may produce a reaction in diseased individuals but not in 

 a normal person when the same dosage is employed. 



Holler, while working with deutero-albumose in patients, tried its effect 

 on himself over a period of over two weeks. In patients the intravenous in- 

 jection of 1 c.c. of a 10% solution was invariably followed by a slight drop, 

 then a rise in temperature of from 2 3 C., a chill, occasionally sweating, rarely 



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