CHAPTER XXXI. 

 ANAPHYLAXIS. 



Dallera, in 1874, and a number of physiologists of that 

 period, observed peculiar skin eruptions following the trans- 

 fusion of blood, that is, the introduction of foreign proteins. 

 In the years subsequent to the introduction of diphtheria 

 antitoxin (1890) characteristic ''serum rashes" were not 

 infrequently reported, sometimes accompanied by more or 

 less severe general symptoms and occasionally death— a 

 train of phenomena to which the name ''serum sickness'- 

 was later applied, since it was shown that it was the horse 

 serum (foreign protein) that was the cause and not the anti- 

 toxin itself. In 1898, Richet and Hericourt noticed that 

 some of the dogs which they were attempting to immunize 

 against toxic eel serum not only were not immunized but 

 suffered even more severely after the second injection. They 

 obtained similar results with an extract of muscles which 

 contain a toxin. Richet gave the name "anaphylaxis" 

 ("no protection") to this phenomenon to distinguish it 

 from immunity or prophylaxis (protection). 



All the above-mentioned observations led to no special 

 investigations as to their cause. In 1903, Arthus noticed 

 abscess formation, necrosis and sloughing following several 

 injections of horse serum in immediately adjacent parts of 

 the skin in rabbits ("Arthus's phenomenon"). Theobald 

 Smith, in 1904, observed the death of guinea-pigs following 

 properly spaced injections of horse serum. This subject 

 was investigated by Otto and by Rosenau and Anderson in 

 this country and about the same time von Pirquet and Schick 

 were making a study of serum rashes mentioned above. The 

 publications of these men led to a widespread study of the 

 subject of injections of foreign proteins. It is now a well- 

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