158 PROTEIN THERAPY 



to be observed on the course of the disease following the injection. 



Thus heterovaccine therapy was, clinically at least, definitely es- 

 tablished and has come to be accepted even when the vaccine is 

 used subcutaneously. Stein in presenting the results on about 1,500 

 cases of typhoid treated by him both subcutaneously and intrave- 

 nously found that by either method of administration colon vaccine 

 would give comparable results. 



The theory could still be advanced that the vaccines injected were 

 more or less related biologically and that group reactions might im- 

 munologically account for the result, an idea that Ichikawa had ad- 

 vanced to account for the success of the typhoid vaccine in para- 

 typhoid fever. 



Milk and Albumoses. Even this last resource of our older concep- 

 tion was swept away with the demonstration of the fact that typhoid 

 fever could be treated with equally good clinical results with intra- 

 muscular injections of milk or intravenous injections of protein 

 products. 



Liidke in 1915 reported on 23 cases of typhoid fever treated with 

 intravenous injections of deutero-albumose and later reported on a 

 series of 78 cases of typhoid fever and paratyphoid B fever with 

 the following results: 



In 26 cases there was a complete, critical defervescence. 



In 10 cases there was a complete defervescence in from 3 to 5 days. 



In 31 cases the temperature came to normal in from 7 to 12 days, 

 while in 11 cases there was no appreciable effect on the temperature 

 curve. 



The deutero-albumose used by Liidke contained about 15% of salt 

 as well as some protalbumose and was used in the majority of cases 

 in 10% solution. In the normal individual the injection of 1 to 1% 

 c.c. of this solution caused no reaction. (In one normal individual 

 a second injection given after an interval of two weeks produced a 

 slight chill and a rise in temperature that persisted for about 4 hours.) 



Liidke has never seen an unfavorable effect on the pulse follow- 

 ing proteose injections in any acute infection. There were no deaths 

 in these 78 cases of typhoid or paratyphoid fever. The average dura- 

 tion of the disease in these cases was from one to two weeks and he has 

 noted, as others have constantly reported, that the earlier the treat- 

 ment is inaugurated, the better the results. 



Perhaps the largest series treated with deutero-albumoses is that 

 of Holler (350 cases). His method of injection differed materially 

 from those heretofore employed in that he gave daily injections, 

 usually commencing with 1 c.c. of a 10% solution and increasing 

 the dose about 0.5 c.c. with each injection, depending of course 

 on the reaction. His cases were all kept on a fluid diet, were given 

 charcoal as well as urotropin, but otherwise had no medication apart 



