THE NONSPECIFIC REACTION 55 



proteins as contrasted to the absorption and metabolism of the car- 

 bohydrates and fats. 



A number of years ago Italian observers noted that in normal 

 animals the injections of small doses of toxins and of tuberculin 

 were followed by an augmentation of the nitrogen metabolism (ex- 

 cretion) followed by a period in which an excess of nitrogen was 

 stored. Animals treated with small doses of tuberculin would gain in 

 weight as contrasted to normal animals without injections. 



Much work has been done during the course of studies on anaphy- 

 laxis, and inasmuch as this simulates the picture that we obtain 

 in nonspecific therapy to a considerable degree, the results are not 

 without interest in this connection. Schittenhelm and Weichardt 

 noted the immediate increase in the nitrogen excretion in anaphylactic v 

 dogs after a shock. Thus one dog from a normal excretion of 1.88 

 gm. per day excreted 2.8, 3.3, 2.65, 2.41 the days following shock, 

 amounts far in excess of the amount of protein injected to produce 

 the shock. Segale noted the same effect and Manoiloff observed an 

 increased excretion of nitrogen in rabbits despite the fact that the 

 temperature had diminished. 



Hirsch and Leschke have studied the same subject in a very 

 thorough manner. They found that with fairly large doses of an- 

 aphylatoxin a negative nitrogen balance obtained, whereas smaller 

 doses or mild shocks often led to a positive balance. They noticed 

 that the excretion of nitrogen did not necessarily bear any direct 

 relation to the temperature of the animal resulting from the vari- 

 ous pyrogenic agents. Breed's studies are also of interest in this 

 connection. 



In the patient the injection of the nonspecific agents with the re- 

 sulting reaction is associated with an increase in the nitrogen ex- 

 cretion just as such shocks are associated with an increased 

 metabolism in animals. In a number of cases that we have followed 

 the total nitrogen excretion of the urine increased from 20% to 30% 

 above that excreted before the injection. After about two days the 

 nitrogen excretion again reaches the normal and for a variable period 

 after this time there exists in many patients a diminution in excretion. 



The Weight of the Patient. Uddgren has followed the weight of a J 

 series of patients given intramuscular milk injections. This included 

 4 groups. In the first were included patients who received "market" 

 milk, with rather severe temperature reactions. In the second were 

 those who received alternating doses of either "sterile" or market milk. 

 In the third group were those who received a series of injections of 

 either the one or the other. In the fourth group were patients who 

 received the "sterile" milk entirely. The results were as follows: 



I. Usually some increase of weight during course of injections. 

 More often a slight decrease followed later by an increase. 



