984 ANAPHYLAXIS AND ANAPHYLACTOID REACTIONS 



a collection of precipitate at both poles, it collects almost entirely at the negative pole. 

 Lumiere' says that mixture of antigen and sensitized serum produces a flocculation, 

 responsible by physical rather than chemical means for anaphylactic shock. The 

 flocculate acting mechanically and abruptly on the endothelium of the vessels of the 

 central nervous system provokes sudden general vasodilatation, the determining 

 factor in the manifestations of shock. Examination of the work of Lumiere, Kri- 

 tschewsky, Doerr and Moldovan, and Kopaczewski, shows that they fail to distinguish 

 between anaphylaxis and anaphylactoid reactions. This, together with obvious 

 objections indicated in discussing the nature of shock and the site of reaction, leaves 

 the hypotheses without secure foundation. 



Jobling, Petersen, and Eggstein^ demonstrated that anaphylactic shock, "is 

 accompanied by (a) the instantaneous mobilization of a large amount of non-specific 

 protease, (b) a decrease of antiferment, (c) an increase in non-coagulable nitrogen of 

 the serum, {d) an increase in amino-acids, (e) a primary decrease in serum proteoses." 

 They conclude that the "intoxication is brought about by the cleavage of serum 

 proteins (and proteoses) through the peptone stage by a non-specific protease" and 

 that "the specific elements lie in a rapid mobilization of this ferment and the colloidal 

 serum changes which bring about the change in antiferment titer." This refers the 

 matter to the effects of poisonous protein products, discussed above in reference to 

 Vaughan's work. Bronfenbrenner^ found that bubbling ether vapor through serum 

 decreases the antitryptic activity, which he believes to be due to an increased dis- 

 persion of the colloidal particles. A similar decrease of antitryptic activity occurs 

 when antigen and antibodies are mixed. The explanation is simpler than that of 

 Jobling but based upon the assumption that shock is due to protein split products. 

 Besredka assumes that the shock dose of protein meets with a preformed sensibilisin 

 in the nerve cells and produces there either a liberation or absorption of energy, 

 thermal or otherwise, and that this reaction leads to the phenomena of shock. The 

 work of Opie quoted below indicates that there is no preformed sensibilisin. Besredka 

 supports his hj-pothesis by the fact that anesthetics inhibit shock. Bronfenbrenner 

 found that certain anesthetics increase antitryptic activity by 100 per cent or more, 

 and assumes that their inhibitory effect is not due to action on nerve cells but is the 

 result of absence of liberation of proteases. 



LOCAL ANAPHYLAXIS (aRTHUS PHENOMENON) 



Described by Arthus-* and studied in detail by Arthus and Breton^ in the skin, the 

 inflammatory reaction following injection of protein in the skin of sensitized animals 

 is known to occur elsewhere in the body. This is true of either actively or passively 

 sensitized animals. Opie'^ has found that the involved area shows necrosis, inflamma- 

 tory exudate of polymorphonuclear leukocytes and other cells, edem.a, fibrin forma- 



' Lumiere, A. : loc. clt. 



^ Jobling, J. W., Petersen, W. F., and Eggstein, A. A.: loc. cit. 



i Bronfenbrenner, J.: Proc. Soc. Exper. Biol, b' Med., 12, no. 1915; 13. i9- iQ^S- 



1 Arthus, M.: loc. cit. 



s Arthus, M., and Breton, M.: Compt. rend. Soc. de biol., 55, 147S. 1903. 



*Opie, E. L.: /. Immunol., 9, 259. 1924. 



