be due to lung abscess. Her convalescence was slow because of the complication.

CASE 3. The patient, M. S., a nurse, entered the ward Nov. 8th having contracted influenza while caring for the first patient discussed. Her temperature, pulse and respiration on entrance were 99.5 degrees, 85 and 22 respectively. Her temperature varied from 101 to 103 degrees until Nov. 12th when the chart showed a definite change; her temperature rose to 103.4 degrees and respirations were increased. Careful examination revealed only a few crackles in the left base with no dullness. She was sent to the X-ray room and evidence of beginning bronchopneumonia in the left axillary region with congestion of the right upper lobe was obtained. On the following day an injection of one-half billion typhoid bacilli was given intravenously. Her temperature rose to 105.2 degrees with an accompanying chill lasting twelve minutes. Eight hours after the injection her temperature had fallen to a minimum of 99.5 degrees after which it began to rise. When it had reached 102 degrees she was again given typhoid bacilli intravenously, the dose this time being one billion. The usual reaction with a rise in temperature to 106.8 degrees axillary followed. Six hours after the injection her temperature had fallen to 99 degrees, but inasmuch as the drop was again but temporary, the same dosage of typhoid was repeated. A chill lasting for twenty minutes followed the injection and the temperature rose to a maximum of 106.7 degrees mouth. Subsequently the temperature dropped to 99 degrees but on the following day it rose to 103.5 degrees. Since a post critical rise had been seen in the other cases it was decided to wait before repeating the protein injection. On the following day the temperature had dropped to 99.2 degrees. On the next day it became normal and remained so during the uneventful convalescence.

It is exceedingly interesting to note that in this case definite physical signs of pneumonia could be demonstrated for the first time on the 15th, the day on which she received her last protein injection, and this in spite of the fact that the area involved had been already localized by X-ray examination. Clearly treatment in this case was begun while the process was still central and the degree of involvement slight. We feel that for that reason the crisis was unquestionably hastened.

CASE 4. The patient, a woman, age 24, entered the hospital complaining of cough, pain in the chest and weakness. She had had symp

toms of influenza for the four preceding days. On examination there was impaired resonance at the left base with bronchial breathing and fine crepitant rales, and a few abnormal signs were present in the right base. The heart apex was one and one-half inches outside the nipple line and a loud blowing systolic murmur heard. at the apex was well transmitted to the axilla. On the morning following admission she was given one-half billion typhoid bacilli intravenously. The usual chill followed and the temperature rose to 106.4. During the afternoon she perspired freely, felt very much more comfortable and the temperature dropped to 101 degrees. On the 13th it began to rise again. The protein injection was repeated. A good reaction followed. The chill lasted for 15 minutes and the temperature rose to 106.5 degrees. Two hours later the temperature had fallen to normal and it remained normal during the uneventful convalescence.

SUMMARY.

1. A citrated blood transfusion which produced a severe reaction was followed by a drop in temperature by crisis and by prompt recovery.

2. Two transfusions with immune blood which caused no reaction were followed by no change in the temperature, pulse, respiration or general physical condition.

3. When typhoid substance was used and a typical protein reaction obtained there was in each instance a sharp fall in temperature and a dramatic improvement in the patient.

4. These results have led us to believe that non specific protein therapy has a very definite and important place in the treatment of influenzal pneumonia.