SOME ASPECTS OF ANAPHYLAXIS 441 



no reaction from the serum of an animal dead from true anaphylaxis, 

 provided that the test was carried out after the total removal of all 

 coagulable proteids, thus leaving the non-coagulable peptones and 

 albumoses in the filtrate. This method, therefore, gives no evidence of 

 any degradation product demonstrable by the biuret reaction (Pfeiffer 

 and Mita). 



The question was attacked in still another fashion by Abderhalden 

 and Pincussohn. If the intoxication of anaphylaxis is produced by the 

 rapid production of toxic cleavage products from the injected proteid, 

 it is legitimate to assume that the serum of sensitized animals should 

 possess ferments which rapidly accomplish this degradation of the 

 proteid molecule. The experimental test was successful in demon- 

 strating proteolytic ferments, but these ferments were not specific nor 

 of very active nature; and later work by Gruber renders their relation 

 to anaphylaxis quite doubtful. 



Summing up the evidence which we have regarding the identity of 

 proteid cleavage products and the causative agent or agents of true 

 anaphylaxis, it must be said that while the assumption is theoretically 

 tenable, a firm experimental basis for this assumption is yet to be laid. 

 Moreover, investigators who unreservedly identify the disturbances 

 caused by proteid constituents produced in vitro, with true anaphylaxis, 

 are causing confusion in another direction. Not only is a perfectly 

 well defined symptom-complex like anaphylaxis obscured by this exten- 

 sion of its scope, but a number of characteristic signs of anaphylaxis 

 lose their significance. Before this can be discussed profitably, the 

 original meaning of the word anaphylaxis as well as the functional 

 disturbances and anatomical signs which characterize it, must clearly 

 be kept in mind. On account of the importance of this, it may perhaps 

 be permissible to give a short resume of matter already discussed. 



Meaning of the Word Anaphylaxis, and Diagnostic Criteria. — What 

 the word anaphylaxis was coined to indicate has already been stated; 

 it means the symptoms and signs which are produced when an organism 

 is resubjected to the action of a foreign soluble proteid. When horse 

 serum, for example, is employed, the first injection causes no untoward 

 effects; the second injection, however, gives outspoken and pronounced 

 results which did not occur after the first injection, and these effects are 

 only obtained when a proper interval has elapsed between the two 

 administrations of horse serum. In active anaphylaxis there are three 

 well-defined stages — sensitization, incubation and intoxication. In 

 passive anaphylaxis, where a normal animal is sensitized by the injec- 

 tion of the serum of a sensitized animal, the same three stages are 

 present, but the period of incubation is now shortened to a few hours. 

 If, therefore, reactions are obtained in an animal after the second or 

 so-called toxic injection which were absent when the first one was given, 



