982 ANAPHYLAXIS AND ANAPHYLACTOID REACTIONS 



a vast excess of immune serum is necessary to produce the reaction. Antigen and pre- 

 cipitin may coexist in serum and in circulating blood; excess of antigen may inhibit 

 precipitation or may dissolve precipitate. It is well known that the actively or pas- 

 sively sensitive animal has a low titre of circulating precipitin, and it is reasonable to 

 suspect that under the conditions of anaphylaxis experiments the necessary equi- 

 librium for the formation of precipitates does not occur. Of further interest is the 

 fact demonstrated by Opie^ that washed specific precipitates produce no obvious 

 injury upon intravenous injections into rabbits. 



ANAPHYLACTIC POISONS 



The term is employed to cover a variety of poisonous substances which are as- 

 sumed to be the cause of shock. Friedberger- produced a poisonous product by incu- 

 bation of antigen, specific precipitin, and complement, to which he gave the name 

 "anaphylatoxin." Doerr and Russ^ found that complement was unnecessary to the 

 mixture. Keysser and Wassermann discovered that the interaction of guinea pig 

 serum and kaolin or barium sulphate produced a similar poisonous substance, and 

 Besredka showed the same to be true of serum and peptone agar. Bordet found that 

 serum and dissolved agar react in the same way. Novy and De Kruif'' discovered that 

 agar alone and other non-protein colloids produce similar symptoms. Vaughan and 

 Wheeler^ demonstrated the intense toxic activity of the split products of protein de- 

 composition and assumed that in anaphylaxis a similar digestion occurs in the animal. 

 That the agar-seruni mixtures show an increase of non-protein nitrogen is an indication 

 that in such mixtures digestion occurs. Jobling and his co-workers'" showed that mix- 

 tures of serum with bacteria or kaolin or agar resulted in adsorption of anti-enzyme 

 with consequent activity of proteases and the production of poisonous products. 

 Dale^ pointed out that the immediate response of the uterus strip is difficult to 

 harmonize with the idea that ferment action is involved. 



These substances are all effective immediately upon injection intravenously, but 

 not upon intracerebral injection (Besredka). The effect is not specific. No such poison 

 can be demonstrated in the blood in anaphylactic shock. Several of the products have 

 been studied by Hanzlik and Karsner and have been shown to produce anaphylactoid 

 rather than anaphylactic phenomena. 



The resemblance of anaphylactic shock to the effects of histamine has been noted 

 by Abel and Kubota,^ Dale, Vaughan, and especially by Manwaring and his col- 

 laborators. Smith' has emphasized the differences between anaphylaxis and histamine 



' Opie, E. L.: ibid., g, 259. 1924. 



2 Editors' Note. — The chapter promised by Dr. Friedberger for this volume was not received. 



3 Doerr, R., and Russ, V. K.: Ztschr.f. Immiiniliilsforsch. u. exper. Thcrap., 2, 109. 1909; 3, iSi. 

 1909. 



-t Novy, F. G., and de Kruif, P. H.: J. A.M. A., 68, 1524. 191 7. 



s Vaughan, V. C, and Wheeler, S. M.: /. Infect. Dis., 4, 476. 1907; Vaughan, V. C: Poisonous 

 Proteins. St. Louis: Mosby, 19 17. 



6 Jobling, J. W., Petersen, W. F., and Eggstein, A. A.: loc. cit. i Dale, H. H.: loc. cit. 



* Abel, J. J., and Kubota, S.: /. Pharmacol. &" Exper. Therap., 13, 243. 1919. 

 'Smith, M. I.: J. ImDinnol., s, 239. 1920. 



