^66 LOCAL TLSSUE RLAC'llVlTY 



mimi/c'd rabbits. 1 he antigens were suspensions ol B. coli, B. ly- 

 l)/iosus, B. pardlypliosus, Slrcplococcus hcttioly liens, and Slaphylo- 

 coccus albus. In the exjjeriinents of this author in which the 

 set-uj) was the same as in the plienonicnon ol local skin reactivity 

 described in this nionoi;raj)h {i.e., an intracutaneous injection fol- 

 lowed iwenty-fom" hours later l:)y an intravenous injection) , re- 

 actions typical of the j)henonienon ^vere obtained. The active 

 j)rin{ij)les of the jjhenonienon were lUHjuestionably present in 

 the bacterial suspensions of R. Kahn and must have played an im- 

 portant role in the elicitation of the "black" reactions described 

 by him. This is indeed well supported by the fact that the reac- 

 tions were only obtained ^vith microorganisms which give the 

 phenomenon and failed with staphylococcus, which gives it only 

 rarely. It appears, therefore, that the reactions investigated by 

 Kahn present essentially a combination of allergic inflammation 

 following the intracutaneous injection of iDacteria into previously 

 sensitized animals, with a superimposed reaction of the phenom- 

 enon of local skin reactivity described in this monograph. 



THE POSSIBLE RELATION OF THE ACTIVE PRINCIPLES OF THE PHENOM- 

 ENON OF LOCAL TISSUE REACTIVITY TO THE ARTHUS 

 PHENOMENON IN MAN 



The occurrence of peculiar reactions interpreted as the Arthus 

 phenomenon in man deserves special consideration. In 1909, 

 Lucas and Gay reported observations on the Arthus phenomenon 

 in a large group of human cases. According to these authors, an 

 immediate localized reaction of anaphylaxis in the nature of 

 edema and infiltration, followed in some untreated cases by 

 necrosis, occurs in human beings on reinjection with diphtheria 

 toxin. The percentage of cases in which these reactions occurred 

 increased directly with the number of injections at short intervals 

 given subsequently to a primary injection. Although the mani- 

 festations of local infiltration in the cases described were of fre- 

 quent occurrence, the incidence of necrosis was rare. Inasmuch 

 as the paper presents a summary of observations on a large series 

 of cases, no individual histories were given by the authors. Ho^v- 

 ever, a ntnuber of cases of Arthus phenomenon of extreme sever- 

 ity in man indicate a feature which seems to be of special interest 

 in that in practically all these cases the patients suffered from 

 some incidental acute infectic^us disease, i.e., dij^htheria, upper 

 respiratory infection, etc. (Koehler and Heilmann, 1923; Gate- 



