128 Active Immunization to Hay Fever [March, 



lowed in twelve days by a second dose of the samesubstance, which did 

 not cause any Symptoms in control animals not previously so treated. 

 Since then much research has been conducted, and many theories 

 suggested, regarding the mechanism of the phenomenon. Our 

 present conception of the modus operandi of anaphylactic shock has 

 been evolved from the work of Vaughan and Wheeler (4) on " spHt 

 proteid," of Sleeswijk (5) and others on the role of complement 

 during anaphylactic shock, and that of Friedberger and Hartoch (6), 

 and Ulrich Friedman (7), on the production of anaphylatoxin in 

 vitro. These investigators have given us the f ollowing hypothesis : 

 When foreign protein is injected into an animal, there is a produc- 

 tion of antibody or amboceptor specific for that particular protein. 

 This amboceptor unites with the antigen. By the action of com- 

 plement in the blood, the antigen then undergoes proteolysis, the 

 proteolytic products inducing the Symptoms known as "anaphyl- 

 actic shock." The antibody is formed after the first injection. If 

 the second injection is given at the proper time, the proteolysis goes 

 on very rapidly, with the production of fractions, or anaphylatoxin, 

 in large proportion, and consequent pronounced Symptoms. 



Hay fever is due, as previously stated, to a sensitization of an 

 individual by the conveyance of pollen contents through the res- 

 piratory tract. There must be, at the time of sensitization, an 

 abrasion of the mucous membrane so as to make parenteral absorp- 

 tion possible. In all likelihood, there exists in the patient an indi- 

 vidual susceptibility to this particular disease, which seems to have 

 some relation to heredity, for this and other allied ailments are fre- 

 quent in given families. Among our patients there are two brothers 

 with hay fever; a brother and sister with hay fever; a woman, 

 with hay fever, whose son suff ers from asthma ; two cases in which 

 a f ather and one or more of his children suffer from hay fever ; a 

 young woman with hay fever who had intense eczema as a child 

 and whose mother suffers with eczema that is rebellious to 

 treatment. 



An attack of hay fever is comparable, in effect, with the Wolff- 

 Eisner (8) tuberculin reaction in the skin or with the Calmette (9) 

 reaction in the eye. During the flowering season of plants, pollen is 

 transported by air currents and is inhaled by all of us. The sus- 



