ARTHUR F. COCA looy 



Ramirez/ A transfusion from the asthmatic donor to one recipient resulted in an 

 asthmatic sensitiveness in one recipient, but not in the second. It seems prol)able that 

 the bronchial shock tissue in the first recipient was in the atopic state, whereas that 

 in the second recipient, who had received a larger quantity of blood than the first, 

 was normal. 



The independence of the several shock tissues from one another seems evident, 

 furthermore, in the difference in the character of the constitutional reactions pro- 

 duced by an overdose of an atopen in different hypersensitive persons. In some, the 

 symptoms are those of asthma only, in others those of hay fever, subcutaneous edema, 

 or urticaria. The atopic state of the same shock tissue exhibits differences in degree 

 in different individuals which are not always parallel with the concentration of the 

 reagins in the blood. One of the numerous mysteries of this subject lies in the fact 

 that the shock tissue may be only slightly susceptible to the natural contact with the 

 atopen, but highly susceptible to the same substance upon its injection, or vice versa. 

 The susceptibility to the injected atopen seems generally to be parallel with the reagin 

 content of the blood. ^ 



A shock tissue can be affected by the subcutaneous injection of an atopen which, 

 under the usual conditions of exposure, does not influence it. A case of eczema of Dr. 

 Horace S. Baldwin, of the Cornell Clinic, is one in point. The individual was subject 

 also to plantain pollen hay fever. On two occasions, an overdose of the pollen extract 

 injected in the course of prophylactic treatment caused a decided exacerbation of the 

 eczema. 



NON-SPECIFIC INFLUENCE OF THE ATOPIC SHOCK TISSUES 



The anaphylactic shock organs of the guinea pig, the rabbit, and the dog are sus- 

 ceptible to various non-specific influences, such as peptone, histamine, and certain 

 "toxic" foreign sera. As in anaphylactic shock, each individual of the same animal 

 species is afi'ected by these materials in the same way; but the different species are 

 affecj:ed in characteristicaUy different manner by the same material. Thus, peptone 

 produces bronchospasm in the guinea pig, but not in the other two animals; it pro- 

 duces the characteristic congestion of the liver in the dog, but not in the guinea pig 

 or rabbit. 



It would seem probable that the several atopic shock tissues also are likewise 

 susceptible to non-specific influences. One may look upon the effect of a cold wind or 

 irritating vapors upon some asthmatic subjects or of dust, to which the individual is 

 not specifically sensitive, as illustrations of this kind of influence. Some persons sub- 

 ject to food idiosyncrasy with gastro-intestinal symptoms cannot tolerate "rough 

 foods"; for example, fresh lima beans or green peas can be eaten in unlimited quan- 

 tities, but the dried beans and peas cause severe symptoms of dyspepsia with head- 

 ache and vertigo. In many instances, Duke remarks, these non-specific influences 

 may be the primary causes of the reaction of hypersensitiveness. Duke has had oc- 

 casion to investigate this point in connection with his study of the astonishing cases 

 of specific cutaneous hypersensitiveness to physical agents (heat, cold, light). ^ The 



' Ramirez, M. A.: New York Stale J. Med., 112, 115. 1920. 



^ Levine, Philip, and Coca, A. F.: op. cil., 11, 435. 1926. 



3 Duke, W. W.: Asthma, Hay Fecer, etc., Literature (2d ed.). St. Louis: C. V. Mosby Co., 1926. 



