INFECTIOUS DISEASES 187 



existed the injections were followed by an increase in the swelling and 

 the stenotic symptoms, the usual effect of nonspecific injections on local 

 inflammatory processes. In 5 cases there was no apparent effect on 

 the disease. 



Paschen has used milk injections to free diphtheria carriers of 

 their throat infection. Of 54 cases 37 were free in from 4 to 6 days, 

 7 in 14 days, while in 10 cases there was no effect of the injection 

 on the throat culture. In emphasizing the fact that the high fever 

 is one of the factors that aids in overcoming the condition, Paschen 

 points out the fact that of these 10 refractory cases 5 did not react 

 with any fever to the milk injections. 



Miiller has also reported that nonspecific injections milk and 

 casein are effective in ridding the mucous membranes of the throat 

 and nasal passages of diphtheria infection in the case of chronic car- 

 riers. 



BACILLARY DYSENTERY 



The war with its attendant epidemics of dysentery both in the 

 military forces and in the civilian populations afforded European 

 clinicians considerable opportunity to study not only the prophy- 

 laxis but the therapeusis of the disease as well, and we now have 

 reports available from a number of sources. Among them Nolf has 

 published several papers which are available in the American litera- 

 ture dealing with both specific and nonspecific intravenous therapy; 

 Adler was perhaps the first to report on the use of milk injections; 

 Holler, in his large series of infectious diseases treated with deutero- 

 albumose injections, has included 50 dysentery cases and Dollken has 

 reported a number treated with milk injections. 



Inasmuch as Nolf's experience was quite extensive, at first with 

 specific serum therapy, then with vaccines subcutaneously admin- 

 istered and later with intravenous bacteriotherapy, it may be of in- 

 terest to quote extensively from his recent paper. 



"The treatment of ulcerative dysentery gave us only temporary results 

 so long as we had recourse to the methods of the books. Specific sero- 

 therapy proved futile. Therefore, because of the inefficacy of these methods, 

 we had, toward the end of the epidemic of 1917, employed vaccinotherapy 

 in the chronic cases that remained. When possible to isolate a dysenteric 

 germ from the intestine, we made and employed an autogenous vaccine; 

 otherwise we used a vaccine of a Flexner bacillus type made from a gelose 

 culture killed by heat. At this time the vaccine was administered subcu- 

 taneously, in progressively increasing doses, the initial dose being usually 

 10,000. To obtain the desired result it was necessary to raise the dose 

 frequently to from 5 to 10 billion. These large amounts of sterilized cul- 

 ture are regularly well tolerated, though often during from twelve to 

 twenty-four hours after the injections, one observes a little fever, headache 

 and lassitude, with more frequent and less consistent stools, sometimes 



