172 PROTEIN THERAPY 



peared in 20 minutes-1 hour. This anaphylactic-like reaction may have 

 been due to a partial sensitization from the previous subcutaneous 

 injections. Three other patients in this series developed a mild type 

 of a very similar condition, on the 3rd intravenous injection. 



The typical temperature curve following these injections revealed 

 a slight fall during the first part of the chill, followed by a gradual 

 rise, which reached its maximum in 4-6 hours, and gradually fell to 

 normal in 24 hours. 



The leukocyte counts during a reaction and following were some- 

 what variable. Usually a mild leukocytosis just before and during 

 the first part of the chill was observed, soon followed by a marked 

 leukopenia, which appeared toward the end of the chill; a count as 

 low as 2,000 being observed repeatedly during this stage of the re- 

 action. This condition was soon followed by a gradually developing 

 leukocytosis, reaching its maximum in 5-7 hours, and remaining mod- 

 erately high for 24-30 hours. A return to normal occurred in about 

 48 hours. 



Meningococcus Vaccine. The second series of 15 patients was 

 treated with killed meningococci in the same dose and at similar 

 intervals as in the gonococcus series. 



The reactions as far as could be determined were similar in every 

 detail to those produced by the gonococcus vaccine. One instance of 

 a t double reaction occurred following the 1st injection, and 1 patient 

 developed this condition after 2 injections. None of this series had 

 had previous subcutaneous or intravenous injections. 



The leukocyte curve, in general, likewise followed that of the first 

 series very closely. One very startling difference was observed be- 

 tween the 2 groups. Over one-half the meningococcus series de- 

 veloped a more or less severe herpes of the lips and mucous membrane 

 of the mouth, first appearing in 48 hours and remaining for 4-7 days. 

 This condition did not follow any but the 1st injection, and did not be- 

 come aggravated or recur when further injections were made in 

 a susceptible person. 



Colon Bacillus Vaccine. This series contained but 9 patients. 

 The reactions were in every way like those produced by meningococcus 

 and gonococcus with the exception that the size of the dose required 

 to produce the same results was very much less. At first a dose of 

 100 million organisms was given, but the reactions were so severe that 

 25 million were finally used as the initial dose, this to be increased 

 if necessary to produce the desired results. 



Deutero-albumose. A secondary proteose made from casein was 

 used (80 mg.) in 4% solution on a series of 4 patients, the initial 

 dose being 2 c.c. The reaction showed some variations from those 

 produced by bacterial suspensions, in that the chill never took place 

 before 1 hour after the injection, and that there was no headache or 



