74 PROTEIN THERAPY 



III. LOCALIZED LESIONS ON A BASIS OF A DIATHESIS. Using this 

 term in the broader significance as defined by Pfaundler, the follow- 

 ing conditions might be included: 



The lancinating pains of tabes which at times follow on nonspe- 

 cific injections, as well as an occasional gastric crisis. 



In paresis the psychic state may be decidedly disturbed and the 

 disease manifestations become more apparent following nonspecific 

 injections. This is not an uncommon experience in the treatment of 

 paresis as outlined by v. Jauregg. In epilepsy an attack may be 

 inaugurated if a large dose of a nonspecific agent is administered 

 (Adrenalin-Benedek) , just as in chronic alcoholics an attack of de- 

 lirium tremens may follow such an injection. 



In this sense we may consider that a latent symptomatology may 

 abruptly unfold its various manifestations following injections of 

 protein. 



Activating Agents. We must for a moment stop to consider the 

 agents that are involved in eliciting this nonspecific reaction. Because 

 of the early work in this field we commonly regard the nonspecific re- 

 action as one that follows the intravenous injection of a vaccine let us 

 say typhoid vaccine, or such protein derivatives as proteoses, or more 

 recently the use of milk (given intramuscularly). Not only do 

 such injections bring about the reaction and the focal activation, 

 but certain general biological alterations such as coincident but remote 

 disease processes, metabolic alterations of endocrine origin, fatigue, in- 

 testinal intoxication, blood-letting, Roentgen exposures, trauma, altera- 

 tions in the skin, chilling, counterirritation as well as certain drugs 

 bring about exactly the same focal alteration. The activation of a 

 tuberculosis by an angina, a remote trauma, the menstrual cycle, by 

 influenza or measles; the provocation of a malarial paroxysm (the 

 result of a splenic focal activation) by an intercurrent disease, by 

 prophylactic vaccination, by severe fatigue, long railroad journeys, 

 overheating, exposure to intense light, chilling or drenching, dietery 

 fault, alcoholic excess and the various other factors that the experi- 

 ence of the war has brought to light; the focal reaction about latent 

 arthritic lesions which Pemberton has described after irradiation, ra- 

 dium, thyroid extract, excitement, etc.; the classical activation of 

 gonorrheal processes by a variety of seemingly remote causes; the 

 precipitation of lancinating pains or a tabetic crisis following a 

 "cold"; the origin of a delirium tremens following a trauma; the 

 onset of pellagrous symptoms after exposure to sunlight; these are 

 but a few examples of a universal phenomenon heretofore com- 

 monly observed but not recognized as having a common back- 

 ground. 



It is very probable that many puzzling clinical manifestations 

 ,and unusual features of certain diseases may readily be explained 



