CHAPTER V 



THEORIES CONCERNING THE MECHANISM OF THE 

 REACTION 



When the clinical results of nonspecific therapy were first made 

 known we were quite at a loss to account for the results obtained. It 

 represented empiricism pure and simple, and being diametrically at 

 variance with current conceptions of immunity and resistance it was 

 to be expected that scientifically trained physicians would be decidedly 

 skeptical the more so since the heroic measures at first utilized to 

 bring about the reaction were not without inherent danger. But when, 

 with increasing evidence of clinical success, the importance of the 

 reaction could no longer be ignored we had to seek for some explana- 

 tion to account for the therapeutic benefit even though we had to 

 recast our entire conception of the mechanism of recovery from disease. 



The evidence of the reaction of the patient the chill, fever, sweat 

 and leukocytosis might all be assumed to have some bearing on the 

 therapeutic result. We knew from experience that after a severe chill 

 the septic case might have a defervescence and recover from the infec- 

 tion. We knew that an intercurrent febrile course might favorably 

 influence a preexisting disease process. We knew that a thorough 

 sweat would frequently relieve the symptomatology of many diseases. 

 And the importance of the reactive leukocytosis in resistance and its 

 significance in prognosis had been sufficiently impressed upon us in a 

 number of diseases, especially in pneumonia. But none of these 

 observable reactions on the part of the patient seemed in itself 

 sufficient to account for the striking effect that occasionally followed 

 the nonspecific injections. 



In examining the published experience of a number of clinics it was 

 found to be a common observation that nonspecific therapy gave best 

 results if used early in a disease process. It was also noted that the 

 beneficial effect from the reaction depended to a considerable extent on 

 its severity; later injections, to which the patient responded with 

 diminished severity, were less efficacious. 



These two clinical observations proved a valuable clew to a partial 

 solution of the mechanism that underlies nonspecific therapy. The 

 fact that the most marked therapeutic effect could be attained early 

 in disease rather than late led to the realization that in injecting the 



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