216 PROTEIN THERAPY 



employed. He describes the result obtained in 7 cases, the first two 

 of which received injections of 5 c.c. of 3% salt solution. Later 

 he used larger doses (about 10 c.c. of a 5% solution) and with these 

 the results were striking. The bleeding usually ceased after a few 

 hours. Injections, given daily, were without reaction on the part of 

 the patient. He is under the impression that the result on coagula- 

 tion is due to the reversal of the exchange between the capillaries 

 and tissues so that there is an actual imbibition of "tissue fluid" and 

 coagulating accelerating substances from the tissues by the blood 

 stream, based on the work of von den Velden. 



Vines would effect hemorrhagic conditions by means of anaphy- 

 lactic shock effects or sensitization. Vines bases his method on the 

 following considerations : 



The intradermal reaction is a modified form of anaphylactic shock 

 of general as well as of local significance, in which the stimula- 

 tion of the thrombogenetic functions of the somatic cells is a salient 

 feature. The changes in coagulability of the blood in anaphylactic 

 shock occur in two stages: a period of acceleration which occurs 

 early, followed by a period of retardation; further, that the predomi- 

 nance of the former or the latter depends on the lesser or greater 

 severity of the shock. The intoxicating injection in a sensitized 

 individual may act as a catalytic agent in inducing the intracellular 

 reactions which constitute the anaphylactic phenomena. In cases of 

 hemophilia, Vines says, the duration of the effect of the intradermal 

 reaction is dependent on the duration of the anaphylactic period. But 

 the shorter or longer duration of this effect is also directly dependent on 

 the greater or lesser severity of the hemophilic condition. 



He describes 3 cases so treated, all being sensitized to sheep serum 

 and small doses of sheep serum injected interdermally after sensitiza- 

 tion. In the first two cases the second injection caused an increase in 

 the blood clotting rate of the individual, which was evidently quite 

 permanent, in the third case the effect was less apparent. Confirm- 

 ing Vines' observations, Rouchetti reports two severe cases of hemor- 

 rhagic purpura which abruptly subsided when serum sickness, with 

 urticaria, followed an injection by the vein of normal horse serum 

 or of serum from the emulgent vein of goats. A similar method 

 to stop bleeding after operation has been used by Neirotti and Viola. 

 Neirotti and Viola report two cases of persisting hemorrhages after a 

 minor operation, finally arrested by the anaphylactic shock from the 

 subcutaneous injection of normal horse serum, eighteen hours after 

 a preliminary injection of 10 c.c. 



Voight treated several cases of scurvy with milk injections and 

 noted a prompt styptic effect, as well as general improvement of the 

 patients. 



