50 



PROTEIN THERAPY 



foci of pathological tissue exist such as sarcoma, tuberculosis, etc. 

 The degree of febrile reaction is independent to a considerable de- 

 gree of the agent or the dosage; it depends on the infection and the 

 state of the patient, i.e., on an individual factor. 



Gow, who early employed heterovaccines, came finally to the use 

 of the colon vaccine as being most dependable, other vaccines such 

 as streptococcus, etc., being followed by little temperature effect. He 

 noted the fact that the reaction varies greatly in different individuals, 

 just as had Schmidt. A dose of 50 million might in one instance 

 cause a severe reaction but little in another. For therapeutic result 

 Gow concluded that a moderate reaction was essential. 



That the injection of bacteria would cause fever and that the reaction 

 depended to some degree on the digestion of the bacteria was noted many 

 years ago. (Gamaleia.) Roux and Lepine had observed the pyrogenic ef- 

 fect of the other protein substances before this, while Charrin and Ruffer 

 determined that the pyrogenic effect of the bacteria was thermostable, that 

 is, they heated the bacterial emulsions to 110 C. and were still able to 

 get the original pyrogenic effect on injection. 



The later studies of Buchner, Schittenhelm and Weichardt, of Fried- 

 berger, Vaughan, etc., are of course well known. 



The Pulse. Coincident with the temperature reaction the pulse is 

 almost invariably increased to some extent, usually about 15 to 30 

 beats per minute. With the onset of the sweating the peripheral dilata- 

 tion brings this down to almost the preinjection level. As a rule the 

 quality of the pulse is not altered, and arrhythmia, if present before- 

 hand, is not increased. Cyanosis is uncommon ; I have observed it only 

 once following an injection of proteoses in a case of typhoid fever. In 

 this case the cyanosis was a transient phenomenon and the patient 



