A Comparative Study of Lymph and Serum Ferments during Protein Shock Reactions

The relation of two phenomena involved in the mechanism of recovery following protein shock therapy is shown in these experiments to be due to changes that concern the lymph rather than the serum. The first of these, the increase in the rate of flow of the lymph, has been suggested by Teague and McWilliams as a possible factor in recovery from infection when due to bacteria proliferating in the lymph spaces and inaccessible to the antibodies of the serum (typhoid). By means of the protein shock, antibody-rich fluids (serum) are forced into the lymph channels. That the antibodies of the serum are augmented following the shock has been demonstrated by Culver (4). With this possibility in mind it is to be expected that bacterial infection not confined to the lymph spaces will not be influenced by shock therapy to the same extent. How far this holds true we are unable to state, although von Decastello (5) has called attention to the fact that while he was able to cause rapid lysis or a crisis in typhoid patients following the shock reaction, the injection of a similar amount of vaccine in typhus fever was without effect. The second factor, the great increase in the antiferment, is clearly due to the amount of the antiferment entering the general circulation through the lymph stream. This accounts for the marked fluctuations observed in the titer of the serum antiferment in patients following protein shock. If, for instance, the original titer of the lymph is less than that of the blood, the first flushing of the lymphatic current into the blood channel will tend to lower the titer of the serum, but with the increased amount in the lymph after the shock the titer of the serum will also increase. Bacteria proliferate best where the antiferment is absent, as Wright (6) has noted in his studies on war wounds, a fact that is also commonly applied in bacteriological technique when we employ ascitic fluids, containing relatively little antiferment, preferably to serum, in culture media. The increased lymph flow that follows the shock reaction would have value then, not only in forcing specific antibodies into the lymph channels, but 'in increasing the antiferment there as well, which would aid in checking the growth of bacteria.