INTRODUCTION 9 



inasmuch as it implies a connection with strictly anaphylactic 

 processes. 



Alechinsky (1935, 193^) proposed the term "angiorrhexis" 

 (vascular rupture) for the lesion of the phenomenon. This term 

 seems to be hardly advisable inasmuch as actual rupture of the 

 blood vessels is only an incidental and rather irregular feature, 

 as 'vvill be noticed from the description of the morphological 

 changes of the phenomenon. 



When both skin-pre}:)aratory and reacting factors are discussed 

 collectively, they are referred to as the "active principles" of the 

 phenomenon. 



The reaction at the prepared skin sites is usually described as 

 hemorrhagic necrosis because of its appearance in the gross. His- 

 tologically, the reaction is predominantly hemorrhagic. As will 

 be seen later, it is possible that the necrosis appears subsequently 

 to a profuse hemorrhage. 



GENERAL COXSmERATIONS CONCERNING THE PHENOMENON 



Skin-preparatory injections of bacterial filtrates employed in 

 this ^vork produce variable but mild primary effects depending 

 on the microorganisms and methods employed for preparation of 

 the filtrates. It is beyond doid^t that the primary reactions are 

 histologically and in the gross conspicuously different from the 

 typical reaction of the phenomenon of local skin reactivity to 

 bacterial filtrates (Chapter vi) . 



Twenty-four hoin^s after the intradermal injection, the pre- 

 pared sites may sho^v no reaction, or local erythema of varying 

 intensity accompanied by s\velling, or s^velling alone ^vithout ery- 

 thema. A primary hemorrhagic reaction is only rarely observed 

 with a limited nimiber of preparations of meningococcus and was 

 never seen ^vith preparations deri\'ed from other microorganisms 

 employed thus far. 



The primary effect of a single intradermal injection of 0.25 

 c.c. of bacteria filtrates was studied on many occasions (Shwartz- 

 man, 1928(7, /;, 1929/;, e) . 



The usual type of primary reaction in the site of the local 

 injection of filtrates of six day old tryptic digest broth cultures of 

 B. f\j)Jiosus was an erythema. The size of the reaction varied from 

 1 X 1 cm. to 2 X 2 cm. in diameter. When four areas of the skin 

 of the abdomen were injected, occasionally diffuse redness ap- 

 peared o\er the entire skin of the a])domen. About 50 per cent 



