200 PROTEIN THERAPY 



In general it may be stated that following the intravenous in- 

 jection of convalescent human serum, normal human, as well as 

 horse or other serum in cases of grave scarlet fever, the patient re- 

 acts with a slight increase in temperature and occasionally with a 

 chill; in the majority of cases this is followed by a prompt lysis or 

 crisis. The toxic manifestations of the infection are usually dimin- 

 ished, the patient feels better, complications are diminished in num- 

 ber, but preexisting complications are not influenced appreciably. 



There seems very little that is specific in the reaction, for it is im- 

 material whether immune streptococcus serum, convalescent serum, 

 normal human or animal serum is used, or whether proteoses (al- 

 bumoses) are employed. Even salvarsan, according to Jochmann, is 

 followed by a typical reaction on the part of the patient, in effect 

 similar to serum injection, so that he considers the employment of 

 the one or the other merely a matter of individual preference. 



SEPTICEMIA 



The treatment of septicemia by means of nonspecific injections 

 has at times undoubtedly yielded brilliant clinical results; more often, 

 unfortunately, there has been no apparent effect on the course of 

 the disease. Perhaps the failures are due to the fact that nonspe- 

 cific therapy has almost invariably been left as a final resort when 

 the patient was quite exhausted and incapable of stimulation. It is 

 to be remembered that the very fact that in the true septicemia 

 we are dealing with bacterial proliferation in the blood stream and 

 that thereby all parts of the organism are already being stimulated 

 or overstimulated as the case may be makes any therapeutic ap- 

 plication of this nature practically hopeless at the very start. Never- 

 theless one does at times witness quite remarkable and dramatic re- 

 coveries by crisis or by lysis after nonspecific injections. The older 

 literature, in which the injection of colloidal metals was dealt with, 

 is quite extensive and need not be reviewed at this time. The re- 

 sults were on the whole inconclusive. While recoveries were observed 

 that seemed definitely contingent on the therapeutic injection; in other 

 cases there was no apparent result. Reichmann (6 cases, 5 deaths). 



In the more recent literature other procedures have been mentioned, 

 some of which seem to have been followed by very favorable and con- 

 sistent results. Brown has discussed the use of the metallic colloidal 

 preparations. Hypertonic sugar has found advocates (Baradulin, 

 Audain and Masmonteil), and immunized blood has also been used 

 (Steel). Wright has suggested a method of using such immunized 

 blood for transfusion. The mode of preparation is to treat the blood 

 of a healthy individual with vaccine, then transfuse the infected in- 

 dividual with such immunized blood. 



