978 ANAPHYLAXIS AND ANAPHYLACTOID REACTIONS 



milk. The essential fact disclosed is that "biological origin is not, per se, the thing 

 that determines the immunological specificity of a given protein, but its chemical 

 composition." The composition and spatial relations of the molecule are the impor- 

 tant features. It is, however, possible that certain groups determine the specificity, 

 but what these groups are has not been clearly determined. 



INHIBITION OF SHOCK, DESENSITIZATION, ANTI-ANAPHYLAXIS 



Shock may be inhibited in a variety of ways, but subsequently the anaphylactic 

 hypersensitiveness returns. Therefore, it seems unjustified to refer to the temporary 

 refractory state as desensitization (see Coca).^ A refractory state follows non-fatal 

 shock for a period of several days or several weeks, with subsequent return of hyper- 

 sensitiveness usually not in the same degree. Besredka has shown that frequently re- 

 peated small doses of one protein, not sufficient in themselves to produce clinical 

 manifestations, effectively inhibit or prevent shock. Lewis^ has found that by the use 

 of the Woodyatt pump "anaphylactic shock can be prevented in sensitized experi- 

 mental animals by giving otherwise fatal doses of diluted antigen intravenously at 

 very slow rates." The refractory state appears in a few minutes after intravenous 

 injection, three or four hours after intraperitoneal injection, and about twenty-four 

 hours after subcutaneous injection. Besredka^ claims to have desensitized by way 

 of the alimentary canal. If an animal be sensitized to two or more proteins, there may 

 be induced a specific inhibition of shock to one of the proteins without altering the 

 sensitiveness to the others. 



There is an extensive literature on inhibition of shock, reviewed by Karsner and 

 Ecker,4 who found that heterologous serums inhibit but do not completely prevent 

 shock. Massini^ assumes that in sensitization and shock there are two elements, non- 

 specific and specific. 



Drugs which depress smooth muscle excitability, those which depress nerve 

 activity generally, in the group of narcotics and anesthetics, those which tend to 

 maintain blood pressure, are pharmacologically adapted to the inhibition or even 

 prevention of shock. Thus atropin, adrenalin, chloral hydrate, ether, alcohol, atoxyl, 

 and numerous other drugs have been employed. Auer* pointed out the influence of 

 atropin, Mita^ stated that it would not protect against a full shocking dose, but 

 Karsner and Nutt* demonstrated a clear quantitative relation. Kyes and Strauser' 

 claim that inhibition of anaphylactic shock can be produced in pigeons by the use 

 of heparin, but Hanzlik, Butt and Stockton'" found no such effect upon the response 



' Coca, A. F.: loc. cit. ^ Lewis, J. H.: loc. cit. ^ Besredka, A.: loc. ell. 



■» Karsner, H. T., and Ecker, E. E.: /. Infect. Dis., 30, 333. 1922. 



s Massini, R.: Ztschr.f. Immnnitatsforsch. u. ex per. Tlierap.,27, 213. 1918. 



* Auer, J.: J. E.xper. Med., 12,638. 1910. 



7 Mita, H.: Ztschr.f. rmniunitdtsforsch. u. exper. Tlierap., 11, 501. 1911. 



* Karsner, H. T., and Nutt, J. B.: J. A.M. A., 57, 1023. 1911. 

 'Kyes, P., and Strauser, E. R.: /. Immunol., 12,419. 1926. 



'"Hanzlik, P. J., Butt, E. M., and Stockton, A. B.: J. Immunol., 13, 409. 1927. 



