144 PROTEIN THERAPY 



vaccine was severe. There was always a very marked rise in temper- 

 ature and with few exceptions a marked chill. The headache as a 

 rule was severe, and nausea of a few hours' duration was not in- 

 frequent. In 3 cases, all alcoholics, delirium developed at the height 

 of the fever, in 1 case continuing for thirty hours. Marked dyspnea 

 was observed in a few cases. In only 5 of their patients did Miller 

 and Lusk deem it advisable, on account of the violence of the re- 

 action, to discontinue the treatment after a single injection. No 

 fatalities occurred as a result of the treatment, but it should be 

 borne in mind that evidence of cardiac weakness or hypertension 

 was considered a centra-indication to the treatment and such pa- 

 tients were not injected. 



Scully later reported on another 24 cases of whom 40% cleared 

 up promptly after a single injection and Thomas, working at St. 

 Luke's Hospital, treated an additional 20 cases. Of these 30% 

 were permanently relieved from pain. 



Other American workers have reported on extended series of 

 cases. Thus Cecil used the method in 40 cases, of which 26 were of 

 the ordinary rheumatic type, 7 acute toxic arthritis and 7 of gonor- 

 rheal origin. Cecil gave typhoid vaccine intravenously, using a 

 dosage of 30 to 100 million. By accident a few patients received 

 a larger dose (400-500 million) but the reaction was not much more 

 severe. Of the rheumatic and toxic arthritides 40% recovered com- 

 pletely in from two to ten days without the use of salicylates. The 

 remaining 20 patients all received salicylates at some time of their 

 stay in the hospital, either before or after their vaccine treatment. 

 Of these 17 were cured or greatly benefited under the combined treat- 

 ment. Cecil noted that while the pain in the joints was frequently 

 completely relieved, a degree of muscular pain persisted in the mus- 

 cles, particularly in the muscles of the back. The seven patients 

 suffering from gonorrheal arthritis made very slow improvement by 

 the vaccine treatment. 



Cecil concludes that the method is undoubtedly efficient in many 

 cases of acute arthritis, but that it is unpleasant for the patient and 

 may be dangerous when administered to improperly selected patients. 

 It is interesting to note that several of his patients developed herpes 

 labialis following typhoid vaccines (we had the same experience with 

 certain strains of vaccine; others never were followed by herpes). 

 One patient developed delirium tremens. 



Snyder has reported a series of 110 cases, in which a relatively 

 small dosage 5 to 10 million organisms was employed, with ex- 

 cellent results. Snyder considers the method more satisfactory than 

 any other at present available. No kidney injury was observed fol- 

 lowing the injections. 



Pemberton treated 19 cases of arthritis with intravenous injec- 

 tions of typhoid vaccineusing 25 million organisms of the U. S. Army 



