244 PROTEIN THERAPY 



toxic degradation products of other organisms. In support of this 

 theory, a resume is given of experiments on tetanus and other toxins, 

 which show that the Reading bacillus, out of a series of organisms 

 investigated, is alone able to reduce the toxicity of these toxins. There 

 is one exception, namely, B. sporogenes (Metchnikoff) , which, how- 

 ever, does not appear to be so potent in this direction as is the Read- 

 ing bacillus." Donaldson suggests that this ability to modify a 

 toxin like that of tetanus may prove to be of value as a means of 

 differentiating various types of proteolytic organisms, while it in- 

 troduces new ideas in regard to the biologic processes going on in 

 septic gunshot wounds. 



In the discussion of the effect of nonspecific injections on the bubo, 

 the influence of the enzyme and antienzyme changes have been fully 

 discussed in their bearing on local inflammatory processes, so that 

 it will not be necessary to repeat the conception of the mechanism in- 

 volved. It should be kept in mind, however, that the effect of non- 

 specific injections is a diphasic one: we deal at first with a peripheral 

 leukopenia, a lowering of the antiferment titer, an increase in the pro- 

 tease, an increase in the permeability of the capillaries, in the irritabil- 

 ity of the nervous system, most probably an increase in the suscepti- 

 bility to intoxication. This is the negative phase which makes its effect 

 apparent on local inflammatory changes by an increase in the symp- 

 tomatology. This phase is followed by a positive one in which the re- 

 verse of all these biological alterations takes place, and usually to a de- 

 gree measured by the intensity of the preceding negative phase. On the 

 basis of this mechanism we can determine to a certain degree what we 

 may expect from nonspecific therapy and what its limitations will be. 

 If, for instance, we have existing a large inflammatory focus with 

 much absorption of necrotic material, with a marked leukocytic re- 

 action and a high temperature, nonspecific therapy will be abso- 

 lutely without effect in the majority of cases because the absorption 

 from the inflammatory focus is already doing the same thing that 

 we would attempt artificially. In a phlegmon the treatment is sur- 

 gical, not expectant or nonspecific. On the other hand, in a lym- 

 phangitis or a lymphadenitis, as Kaiser has shown, excellent results 

 may follow nonspecific injections just as they do in the case of the 

 bubo. 



Despite the fact that Gellhaus has reported favorable results in 

 the treatment of appendicitis by means of collargol injections (in 34 

 cases only 6 were operated) the fact that the nonspecific injection is 

 first followed by a negative phase with intensification of the disease 

 process would, in my judgment, definitely exclude all such and similar 

 acute surgical conditions from the field of its application. 



Gellhaus has reported on a very extended series of cellular inflam- 

 mations (143 cases) treated with intravenous injections of small doses 

 of collargol and seems very much impressed with the possibilities. 



