HYPERSKKSITIVENESS 573 



of the secretions of the nose and paranasal sinnses in allergy. In 

 his opinion there is invariabl}^ a definite increase in eosinophile 

 cells. These results are of interest when one compares allergy and 

 anaphylaxis, since Schwenke (1912) observed an increase in eosino- 

 phile. cells in the lung tissue of guinea pigs dead of anaphylactic 

 shock. Since eosinophilia is present quite often in chorea, in 

 syphilis and all forms of helminthiasis and in certain other patho- 

 logical conditions, one wonders to what extent it is evidence of 

 allergy. The eosinophile cell is said to be the most sensitive 

 reagent in many bacterial infections, disappearing immediately 

 and reappearing as the first favoral)le symptom. It is evident that 

 tlie presence of an abnormal number of eosinophiles in abnormal 

 secretions is presumptive but not conclusive proof tliat the cause 

 of the symptoms is allergic in nature. 



Mechanism of the Allergic Response. — At the present time the 

 histamine theory discussed in the chapter on Anaphylaxis is re- 

 garded by many individuals as an adequate explanation of the 

 mcclianism involved in the allergic response. It is quite well 

 established tliat the intradernuil injection of a dilute solution 

 of histamine will cause a wheal similar in appearance and cytology 

 lo that observed when a specific atopen is injected into the skin 

 of a specifically sensitive individual. While we grant that there is 

 a great deal of evidence that the liberation of a toxic substance 

 (K'curs in the shock organ when the exciting agent reaches the 

 latter, nevertheless, we believe that there is a serious objection to 

 calling this substance histamine. To appreciate this objection one 

 must recall that it is at present a well-established fact that the in- 

 jection of a small amount of histamine into the body causes an 

 increase in gastric acidity. In fact, this procedure is used quite 

 often in the diagnosis of true achlorhydria. If histamine is 

 liberated in clinical allergy, it would seem logical to assume that 

 an increase in gastric acidity would occur during an attack. That 

 such does not occur is indicated by the studies of Criep and 

 "Wechsler (1931). They determined the free HCl and total acidity 

 of the gastric juice in forty jiatients and found that the concentra- 

 tion of each varied from zero to normal. In other words there 

 was evidence of hypoacidity rather than hyperacidity. Others 

 have observed an alkalosis in many patients and ketogenic diets 



