IDIOSYNCRASY AND ANAPHYLAXIS 553 



indicates that immune bodies may develop under conditions in which the 

 action of definite antigens can be excluded. 



It has been observed that an individual who has manifested signs of hyper- 

 sensitiveness in one organ or tissue is apt to become hypersensitive also in 

 another organ, and perhaps to another agent. As already stated, it is largely 

 the place where a substance acts on the body which determines the tissue 

 that will become hypersensitive to a given substance in an individual, and 

 which furthermore determines the character of the symptoms which will 

 develop; the recipient tissue is the one which, as a rule, tends to become 

 hypersensitive. There is, in addition, a specific tendency in some individuals 

 to become sensitive to certain substances, as for instance, poison ivy. Further- 

 more, we cannot exclude the possibility that in certain individuals there may 

 be a greater tendency of a special organ or tissue to be affected, while other 

 tissues are exempt, and lastly, while, as stated, the set of symptoms in a 

 particular tissue or organ-system is usually very similar in different individuals 

 exhibiting idiosyncrasy, irrespective of the agent which has caused the hyper- 

 sensitiveness, nevertheless, minor differences seem to exist; for example, 

 some agents more than others tend to lead to the production of eczema of the 

 skin. 



In discussing the similarities and differences which exist between the experi- 

 mental state of anaphylaxis in animals and idiosyncrasy in man, we have 

 referred to the fact that simple chemical substances, which cannot themselves 

 elicit experimental immunity or anaphylaxis in animals and thus cannot 

 serve as antigens, may induce idiosyncrasy, or, to use a term introduced by 

 Coca, may act as atopens, against which an idiosyncrasy may develop. How- 

 ever, this difference between anaphylaxis and idiosyncrasy has lost much in 

 significance since Landsteiner has shown that relatively simple chemical sub- 

 stances (haptens) may serve as antigens if they are combined with foreign 

 sera serving as carriers. But there still remains a definite quantitative differ- 

 ence between the substances which serve as atopens ("idiosyncratogens") 

 and the substances used by Landsteiner. The latter were organic substances, 

 which were rendered more complex by the introduction of certain groups, 

 as, for instance, the azo group, or they were organic dyes in combination 

 with tyrosin and resorcin, while the former may be very simple inorganic 

 substances. However, as first shown by Obermayer and Pick, also relatively 

 simple inorganic groups like iodine may determine a new specificity if intro- 

 duced into serum protein. There exists a further similarity between certain 

 experimental findings of Landsteiner and observations which have been made 

 in idiosyncrasy. Landsteiner has shown that different stereoisomers may give 

 rise to specific states of anaphylaxis and also that the ortho, para, and meta 

 positions, respectively, of certain groups in the molecule may determine 

 specificities. Correspondingly, Nathan and Stern observed in a person an 

 idiosyncrasy for meta-dihydroxybenzene, although there was no reaction to 

 ortho- or para-dihydroxybenzene. 



It is possible to accomplish a passive transfer of the state of anaphylaxis 

 from one animal to another by injecting blood serum of the anaphylactic 



