PHYSIOLOGY AND BIOCHEMISTRY OF SHOCK 427 



and the sympathetic inhibitory. This is accompanied by the hyperpro- 

 duction of histamine which results in further excitation. The aflBrma- 

 tion of this hypothesis Danielopolu bases on the following: (a) 

 hypotension and hypermobility of certain smooth muscle organs is 

 induced by histamine, similarly to acetylcholine; (b) in anaphylaxis 

 these symptoms are inhibited by atropine which acts only on acetylcho- 

 line; (c) eserine and strophanthin, which do not affect the action of 

 histamine, favor shock; (d) the convulsions which appear during 

 anaphylaxis can only be explained by the action of acetylcholine, since 

 they are not produced by histamine, this is also true of the inhibition 

 of the heart; (e) acidosis accompanies anaphylaxis, while in shock 

 due to histamine there is an alkalosis. He further pointed out that dur- 

 ing histamine shock there is a greater decrease in serum-albumin than 

 in serum-globulin, while during anaphylaxis there is an increase of 

 serum-globulin, and a decrease of serum-albumin. Starvation inhibits 

 anaphylaxis but does not affect histamine shock. Injection of glucose 

 inhibits anaphylaxis but has no effect on histamine shock. The 

 clotting of the blood is not changed in histamine shock but is greatly 

 decreased in anaphylaxis. 



The above described observations of Danielopolu derived from ex- 

 periments involving the use of eserine, etc. may very well permit the 

 accumulation of acetylcholine and thereby be responsible for the 

 symptoms described. However, the claimed relationship of these ob- 

 servations to anaphylaxis occurring under normal conditions may be 

 fortuitous. 



8. Metabolic Changes in Anaphylactic Shock 



a. Liberation of Potassium. Schittenhelm, et al. (1927, 1928) 

 studied the potassium and calcium content of the blood of various 

 anaphylactic animals, particularly the dog and rabbit. Sensitized 

 rabbits immediately after the reinjection of antigen experienced con- 

 vulsion and expulsion of feces, etc. The blood of the carotid artery, 

 portal and hepatic veins drawn within two minutes showed the follow- 

 ing (Table XXIII) results in rabbits. 



In the shock organs the potassium values showed marked decrease 

 (Schittenhelm, Erhardt and Warnat, 1928). The changes in dogs 

 were similar to those of rabbits. 



