246 PROTEIN THERAPY 



while Hofer found that he at times obtained very satisfactory results 

 from milk injections in carbuncles and phlegmons. 



A related procedure is that of the production of a nonspecific reac- 

 tion before some surgical procedure in order to make the patient more 

 resistant to infection and a considerable literature of rather incon- 

 clusive nature has been accumulated. Nucleins were the favorite 

 agents, injections being made usually from 36 to 48 hours previous 

 to laparotomies in order to prevent peritonitis. De Paoli and Calisti, 

 for instance, report on two hundred cases in which such injections 

 were made and an increased resistance against infection claimed. 

 Experimentally they determined that apart from the leukocytosis pro- 

 duced by such injections, bactericidal substances for colon bacilli 

 could be demonstrated in increased amounts after the injections. 



Stracker used milk injections with the idea of increasing the gen- 

 eral resistance of patients before operation and utilized reamputation 

 cases for the purpose. He had observed that in old infected stumps 

 subjected to reamputation, infection of the new area was almost a 

 constant result because of the poor condition of the patient generally 

 and because of the lowered local resistance of the tissues. To in- 

 crease the resistance he injected 10 c.c. of sterile milk three times be- 

 fore the operation, at two-day intervals. In fully half of the cases 

 he observed a focal reaction at the site of the old lesion. His results 

 were as follows: In 43 cases of reamputation without preceding milk 

 injections 10% healed by primary intention; in 72 cases with pre- 

 ceding milk injection 49% healed by primary intention. In 37% 

 of the former cases there was suppuration, while in the "milk" series 

 only 13% suppurated. 



Closely related to these observations is the observation made by 

 Stuhl, that infected wounds heal more rapidly after typhoid inocula- 

 tions. Perhaps the recent paper of Bier's as well as the discussion 

 which followed its presentation at the Berlin Medical Society will be 

 found of particular interest because it covers in a broad way the 

 entire subject of inflammation and our present methods of therapy, 

 with specific, nonspecific and physical means. 



