382 LOCAL TLSSUE REACTIVITY 



ilia(>ic (liallic'sis in \vliicii ilicre may be assmiicd the (onihined 

 effect ol bacterial reactivity Avitli sub.se(|ueiu response to non-re- 

 lated anaphylactic j^rocesses.^ 



In addition to the considerations aboxe mentioned, compara- 

 tive studies ot experimental and sjjontaneoiis lesions in animal 

 and man stiggest the significance oi the phenomenon in the patho- 

 genesis of certain morbid processes. There is a group of cases in 

 which the histological picture points to the possible role of the 

 active princij)les of the phenomenon in their etiology because of 

 the predominance of thrombi \vithin the terminal vascidar bed 

 and hemorrhagic diathesis, although bacteriological inxestigations 

 have failed to demonstrate the etiological factor. In 1925 

 MoschoAvitz described such a case. Recently, Friedberg and L. Gross 

 (1936), and Baehr, Klemperer, and Schifrin (1936) reported 

 cases with identical clinical and anatomical features. The chief 

 clinical findings ^vere thrombocytopenia and piupura ^vith a posi- 

 ti\e totuniquet test and an aciUe febrile anemia. Anatomically, 

 they ^vere distinguished by widespread thrombosis of the arterioles 

 and capillaries affecting practically every organ, and paren- 

 chymatous hemorrhages Avith striking dilatation of the venules 

 and capillaries. It is note^vorthy that these cases occinred in 

 females exclusively, which points to a still luiknowir additional 

 factor in their pathogenesis. 



The role of the jjhenomenon in the production of experimen- 

 tal renal lesions by intravascidar prej^aration has already been 

 described. Morphological studies manifest a striking similarity 

 with focal or diffuse symmetrical cortical necrosis of the kidneys 

 seen in eclampsia and variotis infectiotis conditions (sepsis, scar- 

 let fever, malaria, etc.) , and in epizootic diseases, i.e., hog cholera, 

 swine erysipelas. Although, as already indicated, renal lesions 

 were obtained only when two injections of bacterial filtrate were 



^ It leniains to he seen ^vhether there exists any definite connection between the 

 hemorrhagic lesions pVodiiced bv the active princijsles ot the phenomenon and 

 vitamin deficiency. Marginesii (1934) put guinea pigs on a scorljiUic diet and 

 attempted reproduction of tlie plienomenon at various stages of development 

 of scurvy. Intracardial injections of the toxins showed no reactions in the pre- 

 pared skin site before the development of symptoms of scur\y. Ho^vever, if the 

 injections were made after the appearance of scinvy symptoms, the spontaneous 

 hemorrhagic lesions seen in scorbutic animals (due to the diet) became more 

 conspicuous after the intravenous injection of reacting factors. The refractory 

 state of normal guinea pigs is seemingly well established by doubtfid results of 

 my o^vn and entirely negati\e results of }. Freund. H. Ciross, and irregular results of 

 Gratia and Lin/. 



