THE PROBABLE MECHANISM OF THE REACTION 113 



decided harm to the patient. If, however, it is clearly kept in mind 

 that only clinical improvement and amelioration is sought and the 

 measures used in this sense, then it may have a place in our legiti- 

 mate methods of treatment in inoperable cases. 



This reaction and its effects on the local condition as detailed 

 here is quite similar to that which has been studied in regard to 

 the tuberculous focus and is more fully entered into elsewhere. 



The Reaction in Local Inflammation. It is of paramount impor- 

 tance for the purpose of studying the role of the enzymes in this non- 

 specific reaction to keep in mind the fact already emphasized in the 

 introduction that the reaction of the body to injury, whether chemical 

 or physical or bacterial, is, within certain limits, always the same. In- 

 flammation, no matter how produced, is fundamentally alike in char- 

 acter and in its results. 



If we view recovery from this point of view it is instantly ap- 

 parent that nonspecific therapy offers something more substantial than 

 an evanescent therapeutic fad or a bizarre fancy of the day in medi- 

 cine. It is rather a procedure that has as the foundation of its 

 mechanism biologic processes at once the most primitive and the 

 most universal of all those over which the organism disposes in its 

 measures of defense and resistance to trauma and disease. 



If it can actually be demonstrated that inflammation is altered 

 by nonspecific reactions we can conceive that the hastening of the 

 process will be evidenced in two ways: in one, that a beginning in- 

 flammatory process will subside without suppuration, in the other, that 

 an advanced or rapidly advancing inflammatory process will undergo 

 softening and resolution. As a matter of fact these are precisely 

 the reactions that do take place when we treat local inflammatory 

 processes by nonspecific means, the venereal bubo being a condition 

 of this type that has been extensively studied. (Odstreil, Miiller, 

 Schneller, Antoni, etc.) 



When a bubo is treated by the intragluteal injection of milk 

 one can observe a definite focal reaction which reaches its maximum 

 in from six to eight hours with an increase of pain, local tenderness 

 and hyperemia. Following this a period of analgesia sets in. If 

 such a bubo is taken under treatment early, suppuration never takes 

 place, the process subsiding without it. 



If the local inflammation, on the other hand, is further advanced 

 when treatment is commenced, softening occurs soon after the in- 

 jection, but if further injections are then made no incision or drain- 

 age is necessary, according to Miiller, because the necrotic and 

 softened material is rapidly absorbed. In only one out of 25 cases 

 did Miiller find it necessary to drain the bubo. 



This effect on local inflammatory processes, which has been dis- 

 cussed at greater length in the chapter on The Focal Reaction, can be 

 demonstrated after nonspecific injections wherever the lesion is so 



