HOWARD T. KARSNER 967 



disease following a second injection of horse serum. Doerr' employed the term to 

 indicate protein hypersensitiveness. Others have offered differing definitions. 

 Karsner and Ecker,^ in their elementary textbook, decided that the usage is so con- 

 fusing as to make the term undesirable. Coca^ clearly points out the objections to its 

 use, indicating that etymologically it can include not only increased sensitiveness but 

 also increased resistance. There are, however, certain reactions whose nature is poorly 

 understood, especially as to whether they represent increased sensitiveness or in- 

 creased resistance, and until these are clarified the term "allergy" might be applied. 

 This means a tentative acceptance of the term to cover literally some alteration in , 

 reactions of the organism, whose nature is not as yet specified. The tuberculin reac- 

 tion at the present time is of this order, and the same applies to the peculiar manifesta- 

 tions of reinfection in tuberculosis, as indicated by Krause and Willis. ^ Thus, the use 

 of the term "allergy" becomes restricted in contrast to the all-inclusiveness suggested 

 by several writers. 



The term "anaphylaxis" has come to have a special meaning. Wells^ has fur- 

 nished a definition with qualifications which meets the views of many authorities. 

 "The term anaphylaxis should be restricted to the condition of hypersensitivity to 

 definitely antigenic substances," with the following limitations: 



1. The observed toxicity of the injected material must depend upon the sensitization of 

 the animal; i.e., the substance must not produce similar symptoms in non-sensitized animals. 



2. The S3^mptoms produced must be those characteristic of anaphylactic intoxication as 

 observed in the usual reactions with typical soluble proteins, being therefore the same for 

 all antigens with the same test animal, but differing characteristically with each species of 

 animal. 



3. It should be possible to demonstrate passive sensitization with the serum of sensitized 

 animals. 



4. It should be possible to demonstrate typical reactions in the virgin guinea pig uterus 

 strip. 



5. It should be possible to demonstrate amelioration or prevention of the bronchial 

 spasm in guinea pigs by proper use of atropin and epinephrin. 



6. The possibility that the observed symptoms are caused by capillary thrombosis or 

 embolism must be excluded. 



7. After recovery from anaphylactic shock there should be exhibited a condition of 

 desensitization under proper conditions. 



Coca^ objects to No. 5 because of experiments, at that time unpublished, showing 

 that in passively sensitized guinea pigs a maximal dose of epinephrin did not prevent 

 the appearance of shock following a minimal dose of antigen. 



The term "atopy" has been devised by Coca^ "to designate the inherited hyper- 



' Doerr, R.: Ergehn. d. Hyg., Bakleriol., u. Immunilatsforsch., i, 257. 1914; 5, 7i- 1922. 



2 Karsner, H. T., and Ecker, E. E.: The Principles of Immunology. Philadelphia and London: 

 Lippincott, 1921. 



3 Coca, A. F.: Arch. Path. &" Lab. Med., i, 96. 1926. 



-i Krause, A., and Willis, H. E.: Am. Rev. Tuberc, 14, 316. 1926. 



5 Wells, H. G.: The Chemical Aspects of Lmnmnity. New York: Chemical Catalogue Co., 1925. 

 ^ Coca, A. F.: Essentials of Immunology for Medical Students. Baltimore: Williams & Wilkins, 

 1925. 



