ROLE OF INFLAMMATION 1 49 



primary reactions not detectable with the naked eye. This appear- 

 ance of the prepared skin site preceding the intravenous injection 

 is indeed in very sharp contrast to the chaniatic hemorrhagic and 

 necrotic lesion elicited a fe^v hours after the intraxenous injection. 

 As will he seen later from the experiments described by Gerber, 

 dilutions above 1:150 produce a primary microscopic inflamma- 

 tory reaction, which by no means exceeds the effect of an intra- 

 dermal injection of saline. 



The facts brought out are amply corroborated by the ^vork of 

 \arious authors. Plant (i9^^2) described the use of a material 

 deri\ed from Sjjiyocheta pallida endowed xvith phenomenon- 

 producing potency, xvhich produced insignificant primary reac- 

 tions. Old cultures incapable of eliciting the phenomenon gave 

 stronger primary reactions than those endowed xvith the phenom- 

 enon-producing potency. J. W. Mu (1935) who elicited the phe- 

 nomenon with extracts of Ascaris luftibricoidis, also notes that 

 the intensity and size of primary reaction is in no way related to 

 the reaction following the intravenous injection of the potent 

 material. According to Joukow-Werejnikow and Lipatova (1933- 

 34) , various chemical fractions of plague bacillus totally inactive 

 for elicitation of the phenomenon may e\oke as much primary 

 reaction as those xvhich possess a high phenomenon-producing 

 potency. 



Bacterial filtrates differing in the concentration of their pre- 

 paratory factors may produce eqtially severe primary reactions, 

 and frequently, those possessing a low skin-preparatory potency 

 may elicit stronger primary reactions than filtrates of high skin- 

 preparatory potency. It has been my frequent observation that 

 meningococcus "agar washings" filtrates possessing a skin-prepara- 

 tory potency ranging fjetween 10 to 50 units per 0.25 c.c, when 

 undiluted produce considerably stronger inflammation than ty- 

 phoid "agar washings" filtrates containing from 50 to 300 pre- 

 paratory units, when used undiluted. Stolyhwo (1935, 1936) ob- 

 served that B. paratyphosus "agar xvashings" filtrates gave stronger 

 primary reactions than B. typhosus "agar washings" filtrates. In 

 this case also, B. paratyphosus preparatory factors are ordinarily 

 of lower skin-preparatory potency than the B. typhosus filtrates. 

 He is of the oj)iiiion that the intensity of the jjrimary reaction is 

 completely independent of the hemorrhagic necrotic reaction fol- 

 lowing the intra\enous injection. 



Apitz (1933/^') obtained excej^tionally strong j)rimary reactions 



