CHAPTER XVIII 

 INDICATIONS AND CONTRA-INDICATIONS 



Protein therapy offers a potent, perhaps the most potent, method 

 that we have at our command of altering the current of cellular 

 activity in two diametrically opposite directions acceleration of 

 function and depression of function. If the agent that we inject is 

 very toxic and the dose large, acceleration soon gives place to fatigue, 

 to complete exhaustion and finally to death; if relatively large doses 

 are repeatedly given the condition of protein cachexia, observed in 

 experimental animals, might supervene. Proper dosage, on the other 

 hand, results in transient but well marked stimulation without clini- 

 cally apparent fatigue, and if continued for a period of time the altera- 

 tion of acceleration and depression of metabolic processes becomes 

 clinically manifest in increased weight and general well being. 



It is apparent how far-reaching the field of application must be 

 and how difficult to make definite rules of procedure or to advocate 

 certain methods or preparations. The extent of usefulness of a method 

 that is a true "plasmaactivation" in the strict sense of the term for- 

 bids a definite delimitation to narrow confines. But despite theoretical 

 possibilities, actual practice might perhaps reduce the clinical appli- 

 cation to very modest dimensions. In this connection I would quote 

 the opinion of Schmidt, who believes that we shall some day come 

 to regard a course of protein therapy in the same light that we now 

 do a changetin diet, a change in climate, a course of baths ; that is, apart 

 from its usefulness in acute diseases, we shall accept protein therapy 

 in its various modifications as one of the very first and the most com- 

 monplace*of methods of therapy. 



With these considerations in mind we can intelligently apply 

 protein therapy in infectious diseases only if we fix very firmly the 

 concept that nonspecific therapy is purely a method of stimulation 

 whereby all the forces of cellular and humoral resistance are for a 

 short period of time keyed to the very highest pitch and by reason 

 thereof, stimulation of this character is useless when the cells of the 

 body are profoundly fatigued. 



As with other new therapeutic procedures there is still some un- 

 certainty as to the proper dosage. Especially is this true because 

 the dosage depends to some extent on the vigor of the patient, on 

 the type of infection which is causing the disease, as well as on the 

 stage of the disease. There is no unanimity of opinion whether it 



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