C H A P T K R V I 



ROLE OF INFLAMMATION IN THE PHENOM- 

 ENON OF LOCAL SKIN REACrmTTY- 

 OPIIMUM CONDITIONS FOR REPRO- 

 DUCTION OF THE PHENOMENON 



INTRODUCTION 



THE opinion was voiced ])y Opie, Menkin (1931) and Kars- 

 nei and Moritz (1934) that the inflammation following the 

 preparatory injection brings about a local concentration of 

 the injurious bacterial products subsequently injected intrave- 

 nously and thus is responsible for the lesions obtained. HoAvever, 

 an assumption of tliis sort cannot be accepted unless it is shoAvn 

 that an inflammatory reaction per se is sufficient to obtain a local 

 jjreparedness to the subsequent intravenous injection. As a mat- 

 ter of fact, their hypothesis is contradicted by a mass of unques- 

 tionable evidence described in this chapter. It ^vill be seen that 

 there is no correlation Avhatsoever bet^veen the primary reaction 

 to the intradermal injection of a bacterial filtrate and the ability 

 of the prepared site to respond to the provocati\'e injection. The 

 lack of correlation is clearly demonstrated by macroscopic and 

 microscopic observations. A great variety of non-bacterial sid)- 

 stances of various properties and producing various degrees of 

 inflammation and vascular damage fail to prepare the tissue 

 to the provocati\e injection of potent principles. Moreover, the 

 j)henomenon described can be elicited only pro\'ided suitable 

 routes are employed for the injections. 



From the facts jjresented, the ima\oidable conclusion is to be 

 drawn, and this is borne out by the observations of most of the 

 investigators in the field, that quite apart from the non-specific 

 inflammation (which may also be almost completely absent luider 

 some conditions of experimentation) , the phenomenon is con- 

 tingent ujDon the elicitation of a certain state of reactivity by 

 means of the bacterial active principles described. This state 

 represents a modified response to the injurious effect of toxic 



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