212 PROTEIN THERAPY 



is tested with peptone to rule out the possibility of his being sensitive 

 to it. We feel that this fad of injecting patients with proteins to 

 which they are not already sensitive is, in general, apt to be a mis- 

 take; the possibility of sensitizing patients to proteins, exclusive of 

 typhoid vaccine, seems to outweigh the chance of improvement by such 

 treatment." 



On the basis of the fact that in antianaphylasis (or desensitiza- 

 tion) a nonspecific element is at times observed, other methods have 

 been devised which are at times applied more easily than the spe- 

 cific methods that Walker has used. Only larger clinical experience 

 will enable us to draw conclusions. It must be borne in mind, too, that 

 our conception of protein therapy must not be limited to the intra- 

 venous injection of typhoid vaccine or peptone. Many of the milder 

 reactions continued over a longer period of time may be found much 

 more effective. 



Auld has reported on the use of peptone injections (dissolved in 

 physiological salt solution to which a small amount of sodium car- 

 bonate is added) given either intravenously or subcutaneously. This 

 treatment has been instructive in respect of the grouping of asthmatic 

 cases. Two main groups occur which show no tendency to pass into 

 each other. One group comprises such as quickly respond to the 

 treatment, and the effect is more or less lasting, the recurrences being 

 infrequent and milder in character. The other group is resistant, 

 and is subdivisible into such as are totally resistant and those in which, 

 by careful immunization, the disease may be largely overcome. 

 Pagniez and Widal, Abrami and Brissaud use peptone by mouth and 

 Cordier uses peptone enemas. The peptone seems to be polyvalent for 

 most of the substances causing the anaphylaxis. Some require the 

 continuous use of the peptone; others do better when it is given for 

 three to eight days followed by an interval of the same length. By 

 this means they have succeeded in curing the tendency in time in 

 many cases, the time required for complete desensitization depending, 

 however, on the personal equation. Other observers have used col- 

 loidal metals and Boyd reported that he had successfully treated 

 several cases of asthma with typhoid vaccine (50 million organisms 

 intravenously). Danysz considers that the intestinal flora furnish the 

 substrate for the antigen which sensitizes the patient in asthma, 

 in certain skin and gastro-intestinal diseases. In an antiphylactic 

 treatment he uses the bacteria isolated from the stool for subcutaneous 

 injection with apparently good results. 



Together with Miller we have used Intravenous injections with 

 typhoid vaccine in asthma in a number of cases. In some the results 

 were quite satisfactory, in others there was no apparent effect on 

 the attacks; the latter group including particularly the cases in which 

 food sensitization was demonstrable. It is possible that a method such 



