HOWARD T. KARSNER 985 



tion, and vascular thrombosis. If washed precipitate be injected, the reaction is 

 milder and no necrosis is observed. Auer' found that in animals with both antigen and 

 antibody present, the production of local irritation (xylol on the rabbit's ear) leads to 

 an intense necrotizing inflammation, evidently due to concentration of the two bodies 

 locally. Opie^ found that if rabbits be given protein intravenously and several hours 

 thereafter intradermal injections of antihorse serum, a local reaction of the same 

 nature occurs, reverse passive local anaphylaxis. As a result of his extensive studies 

 Opie finds that "acute inflammation occurs when antigen and antibody come into 

 contact within the tissue. It is unnecessary to assume that the tissue has undergone 

 any change in the process of 'sensitization.' The combination of antigen and antibody 

 acts as an inflammatory irritant and the usual phenomena of inflammation ensue." 

 The relation of the Arthus phenomenon to human hypersensitiveness is discussed 

 elsewhere in this volume by Coca,^ and to the tuberculin reaction by Long.i 



ANAPHYLACTOID REACTIONS 



Certain agents, when introduced parenterally, produce symptoms and signs which 

 closely simulate those of anaphylactic shock. These have been called "anaphylactoid 

 reactions." Hanzlik and Karsner^ have studied the effects, more especially following 

 intravascular and intraperitoneal injections, of non-nitrogenous colloids, colloidal 

 metals and their salts, tissue extracts, sera, nitrogenous cofloids and mixtures, micro- 

 organisms and vaccines, arsphenamin, coal-tar derivatives, salts of heavy metals, 

 other salts, adsorbents, hypertonic solutions, and certain other materials. The reac- 

 tions include phenomena which have been described as nitritoid crises, hemoclasis, 

 coUoidoclasis, and the responses to certain anaphylatoxins. Our discussion follows 

 closely the admirable review by Hanzlik.'' 



The studies of Hanzlik and Karsner were concerned with fifty-three agents, unre- 

 lated physically and chemically, most of which were not protein in nature. Guinea 

 pigs, rabbits, cats, and dogs were employed and little difference in reaction discovered. 

 Hanzlik has done further work with pigeons; symptoms have also been studied in 

 horses, goats, and man. Rats are said to be refractory, but it seems likely that the 

 results of Scott and Thatcher^ are of anaphylactoid character. 



Intravascular injections, into veins, arteries, or heart, are the most effective and 

 give most uniform results. Forssmann's* carotal complex is probably to be explained ■ 

 on this basis. Intraperitoneal and subcutaneous injections are less effective and less 

 uniform. 



In a general way, "the symptoms consist of increased reflex excitability, rapid 

 respiration and dyspnea, sneezing, retching, jerky spasms, slowing or acceleration of 



' Auer, J.: /. Exper. Med., 32, 427. 1920. ^ See chap. Ixxv of this volume. 



= Opie, E. L.: /. Immunol., 9, 255. 1924. ^ See chap. Ixxvi of this voluipe. 



s Hanzlik, P. J., and Karsner, H. T.: /. Pharmacol, b" Exper. Tlierap., 14, 229, 379, 425, 449, 

 463, 479- 1919-20. 



^Hanzlik, P. J.: J. A.M. A. , S2, 2001. 1924. 



V Scott, W. J. M., and Thatcher, H. S.: Arch. Path. &' Lab. Med., 2, 806. 1926. 



* Forssmann, J.: loc. cit. 



