54 PROTEIN THERAPY 



quite generalized rash in an arthritic patient that came on within 

 three hours after the injection and had disappeared after 24 hours; 

 other observers also report that skin manifestations are uncommon 

 in their experience. 



Headache. Headache of the frontal region is a common symptom 

 following typhoid and colon vaccine injections, but is observed less 

 frequently after milk and other substances. The headache is not as a 

 rule of long duration, lasting usually not more than two or three hours 

 after the chill. 



Delirium. In diseases associated with marked intoxication, such 

 as typhoid, typhus and erysipelas, the intravenous injection of non- 

 specific agents may at times be followed by intensification of the 

 disease manifestations and among them delirium may at times be ob- 

 served. It is usually a very transient phenomenon that disappears as 

 soon as the febrile reaction diminishes; only rarely does one observe 

 any disorientation that persists past the reactive period following the 

 injections. Care must of course be observed in excluding alcohol- 

 ics from nonspecific injections, for such patients may develop a de- 

 lirium tremens during the reaction which, once elicited, may lead 

 to a fatal termination. Several such cases have come to our atten- 

 tion. 



Glandular Activity. Weichardt has carried out a number of ex- 

 periments in which he has shown that the injection of moderate 

 amounts of protein split products increase glandular activity. He 

 demonstrated this in lactating goats as well as for the salivary glands 

 of a number of animals. Dollken has reported an increased secretion 

 of bile following milk injections. 



The question of the galactagogue effect of parenteral injections of 

 milk, of interest to the pediatrician, has been the subject of con- 

 siderable investigation, but has not been conclusively settled. 



Slawik, during the course of his work with nonspecific injections 

 in infants, had occasion to inject several wet-nurses. Dunkan is said 

 to have observed a galactagogue effect after the injection of milk 

 parenterally in lactating women, but Slawik in his cases was not able 

 to confirm this result. Lonne has published observations that indi- 

 cate an increased secretion of milk after parenteral injections, but 

 his conclusions have been criticized by Kirstein, although the latter 

 does not deny the possibility of glandular activation. 



Nitrogen Metabolism. The nitrogen balance shows considerable 

 variation both experimentally and clinically following the parenteral 

 introduction of the proteins and their split products. It is of course 

 beyond the scope of this discussion to examine so-called specific 

 dynamic effect of proteins in their general effect on the normal metab- 

 olism after ingestion, although certain facts that have been derived 

 from a study of this field indicate that there are fundamental differ- 

 ences involved in the cellular reactivity incident to the digestion of 



