Chapter XII 



IMMUN()L()(;IC:AL. pa IHOLOCilCAL. AND 

 CLINICAL SK.NIFICANCE OF THE PHE- 

 NOMENON OF LOCAL TISSUE REACTIVI 1 Y 



IN THIS chapter attempts will ])e made to utilize the data 

 accjiiired for elucidation of certain problems of bacterial 

 allergy and also determine the relationship that may exist 

 between the plienomenon of local tissue reactivity and certain 

 spontaneous diseases of man and animals. 



THE RELATION OF THE PHENOMENON TO BACTERIAL ALLERGY 



Under the heading of bacterial allergy or bacterial hypersensi- 

 tiveness is included an altered reactivity of the host to bacteria 

 and their products. Although bacterial hypersensitiveness belongs 

 essentially to anaphylaxis it possesses definite distinguishing fea- 

 tures clearly brought out by recent contributions of Zinsser 

 (1931) , Doerr (1929) , and others. The classical and best studied 

 example is tuberculin hypersensitiveness, although also observed 

 in other infections {i.e., allergies to mallein, abortin, typhoidin, 

 trichophytin, etc.) . The allergic state is demonstrable by skin 

 tests (also ophthalmic and Long's spermatocyte tests) ; general 

 and focal reactions and protracted anaphylactic shock. 



The skin reaction obtained is different from the immediate 

 erythema and wheal of true anaphylactic sensitization and con- 

 sists of s^velling, redness and induration at the injected site. After 

 a latent period of a few hours there is slo^v progressive local 

 inflammation (with- frequent central necrosis and hemorrhage) , 

 which reaches its maximum in twelve to forty-eight hours. The 

 lesions are similar to those produced by bacterial toxins (Schick, 

 Dick; B. dysenteriae toxins Zinsser and Tamiya, 1926) . 



The general effect of injections of a bacterial antigen into an 

 allergic animal consists of a febrile and toxic reaction. This re- 

 action is clearly different from anaphylactic shock. Tubercidin 

 injected intravenously into tuberculous guinea pigs does not 

 produce spasms of bronchi, but simply a delayed death. 



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