204 PROTEIN THERAPY 



confirms the harmlessness of the method for all ages. The general 

 health improves, the duration of the disease is shortened, and con- 

 valescence sets in earlier. The benefit was more pronounced the 

 earlier the injections had been begun. His report represents exten- 

 sive research by the different physicians on the hospital staff, much 

 experimental and laboratory work being carried on preliminary to and 

 during the clinical experiences. Nolf's technic was closely followed, 

 except that the acidity of the solution of peptone in physiologic salt 

 solution was reduced to 4.3 per thousand, and the remedy was put 

 up in 5 c.c. capsules. About 10 c.c. was given as the first dose, to 

 robust adults; otherwise from 4 or 5 c.c. For older children, up to 

 6 or 8 c.c. giving afterward only about half of the initial dose, and 

 allowing an interval of forty-eight hours to elapse. In almost all the 

 cases a second injection was given and, exceptionally, a third, with 

 only 1 or 2 c.c. A subcutaneous injection of 2 or 3 c.c. of 20 or 25 

 per cent, camphorated oil was given every six hours day and night, 

 with 0.25 c.c. of 1 per thousand epinephrin in each syringe. The 

 patient must be kept in repose. The blood pressure falls during and 

 immediately after the intravenous injection of peptone, but if it is 

 made slowly (1 c.c. per minute) and if epinephrin has been given, 

 the drop is slight. The coagulation time of the blood is much re- 

 tarded. Analysis of the blood showed that the urea content could be 

 disregarded with this protein therapy as the latter only slightly aug- 

 mented it, and it soon dropped to below its previous figure from the 

 rapid reaction to the injection, while the dietetic restrictions in 

 typhus aid in its being speedily cast off. Analysis of the urine like- 

 wise showed that the injections of peptone had no detrimental in- 

 fluence on the kidneys and hence there were no centra-indications 

 on the part of the kidneys, except, of course, with grave nephritis. 

 There are no characteristic findings in the urine in typhus. The 

 fever charts given show the attenuating and abbreviating influence 

 of the protein therapy better than anything else. An interesting fea- 

 ture of the cases was that when the temperature had gone down un- 

 der the injections, a further injection did not induce any appreciable 

 reaction. The production of antitoxins can then be regarded as suffi- 

 cient and the case as cured. In every case improvement in the general 

 condition was unmistakable. 



Opazo reports the application of Nolf's method in 27 cases of 

 typhus, with 14 recoveries, 4 in convalescence and 7 still under treat- 

 ment ; 2 of the patients died, but the disease in their cases had reached 

 a stage when reaction was no longer possible. He reiterates that the 

 protein therapy induced a favorable reaction which modified the 

 disease and all the symptoms. In his experience the reaction was 

 prompter and more effectual in children than in adults. He is now 

 applying this protein therapy as the routine in all cases of typhus. 



Kalberlah reports good results from the intravenous injection of 



