SKRIT.M lUvVCTIOXS 



307 



minutes and then adsorbing it at 4° C. with sterile washed kaolin 

 for fifteen minutes. For a discussion of the treatment of the 

 thermal reaction the student is referred to the reports of Bullowa 

 (1937) and MacLeod (1939). 



The term anaphylactoid has been applied to phenomena in the 

 lower animals characterized by anaphjdaetic-like symptoms, cardiac 

 dilatation, hemorrhages and thrombosis. Apparently the symp- 

 toms and pathological changes are nonspecific in that they do not 

 depend upon a natural or acquired hypersensitiveness to a par- 

 ticular substance. Karsner (1928), and Hanzlick and Karsner 

 (1919-20), who have studied this reaction in the lower animals, 

 noted it more frequently following intravenous than inti-aperi- 

 toneal or subcutaneous injections. 



3. Specific reactions: (a) A third group of individuals wlio 

 may give a severe reaction to the injection of antiserum are those 

 who are mtiuralh/ sensitive to such animal protein, just as others 

 are sensitive to feathers, face powder, or ragweed pollen, and 

 develop hay fever or asthma when the exciting agent is injected or 

 i-eaches the mucous membrane of the nose or intestine or other 

 ''shock organ." These people are said to be "atopically" sensi- 

 tive. They react to much smaller doses of tlie serum and also 

 react more violently than thase who have been made sensitive by a 

 previous injection of serum. They may react violently to intra- 

 dermal or subcutaneous injections and they cannot be desensitized 

 quickly by administering small doses of the serum. Vaughan 

 and Piper (1937) have collected thirty-five cases from the litera- 

 ture in which death followed the administration of horse serum. 

 In six of these the serum had been administered intracutaneously. 

 Park and Williams (1933) state that about 1 in 10,000 persons 

 develop severe reactions and alarming symptoms, and about 1 in 

 50,000 die within a short time after the subcutaneous or intra- 

 muscular injection of antitoxin. According to Tuft (1937) the 

 incidence of fatal serum reaction is about 1 in 70,000. 



(b) Another group giving immediate specific reactions to serum 

 is made up of individuals who have acquired hypersensitiveness 

 to horse proteins through a previous injection of horse serum. 

 This may have been in the form of a previous injection of diph- 

 theria, tetanus, Welchii or scarlet fever antitoxin, or from the 

 injection of normal horse serum antipneumococcus, antistrepto- 



