55^^ LOCAL ILSSLE REAC^TIVITY 



3. Incidental iniicascd jK'rnical)ility ol the blood \e.ssels whidi 

 allows tlie passage ol the active prin( ij)ies Irom the blood streain 

 into the prejxired site, and finally, 



1- The injuiy jjioduced by the active principles introduced 

 into the blood stream. 



The state ol reactivity elicited by the bacterial active jjrinci- 

 ples presents a special interest. The ]:)rinciples possess chemical 

 and innnunological properties ^vhich ally them closely to soluble 

 bacterial toxins. They are antigenic, specifically neutralized by 

 imnuuie sera and are related to important antigenic components 

 of" the bacterial cells. The state of reactivity may or may not be 

 associated with inflammation. A great niunber of observations 

 have afforded tmcjiiestionable proof that the jirimary injection 

 may induce the reactivity in spite of complete absence of primary 

 erythema and may fail to elicit it in the presence of active in- 

 llannnati(m produced either l)y certain inactive bacterial filtrates 

 or l)y a great variety of non-bacterial inflammatory and otlierwise 

 injurious sid)stances. Recently, Opie, V. Menkin, and Cannon and 

 Pacheco emjjhasized fixation of colloidal j^articles in the ])lood 

 stream by inflamed tissues. If one should grant that some sort 

 of inflanmiation is in\ariably elicited by skin injection of a 

 bacterial fdtrate. then this fixation may serve the good purpose 

 of bringing the active principles introduced into the general cir- 

 cidation to the prepared skin site and it thus brings information 

 as to the mechanics of the phenomenon. This alone, however, by 

 no means explains why a severe reaction takes place only in areas 

 j:»repared \vith bacterial filtrates of ascertained skin-preparatory 

 j)otency and fails to occur in other sites in \vhich inflammation 

 results from non-bacterial substances. For these reasons it must be 

 concluded beyond any ck^ubt that the acti\e principles ot the 

 phenomenon possess the ability of inducing in addition a certain 

 state of reactivity, ^vhich makes the phenomenon possible. 



As may be seen from the presentation of facts in this and other 

 chapters of this monograph, the state of reactivity w ith ^vhich one 

 deals in this j:)henomen()n is not in the natme of mere trauma, 

 is not due tt^ the local blockade of reticido-endothelial cells, is 

 not due merely to increased permealoility of the caj)illaries or to 

 inflammation, and is entirely mirelated to true anaphylaxis. Thus, 

 it becomes necessary to assume that the reactivity is due to some 

 fiuutional distiubance in the cells Avhich recjuires a short incuba- 

 tion period for its appearance and ^vhich rapidly disappears. 



