ANAPHYLAXIS 291 



taught by the author before he had read Vaughan's theory 

 along the same hues. 



On the basis of the author's theory the phenomena of 

 protein immunity and antianaphylaxis may be explained in 

 the following way, which the author has not seen presented : 

 The enzymes necessary to decompose the injected protein 

 are present in certain cells and are formed in larger amount 

 b}^ those cells to meet the increased demand due to injection 

 of an excess of protein. They are retained in the cell for 

 a time at least. If a second dose of protein is given before 

 the enzymes are excreted from the cells as waste, this is 

 digested within the cells in the normal manner. If a third 

 dose is given the cells adapt themselves to this increased 

 intracellular digestion, and it thus becomes normal to them. 

 Hence the immunity is due to this increased intracellular 

 digestion. 



On the other hand, if the second injection is delayed long 

 enough, then the eoicess enzyme, but not all, is excreted from 

 the cells and meets the second dose of protein in the blood 

 stream and rapidly decomposes it there, so that more or less 

 intoxication from the split products results. This uses up 

 excess enzyme, hence subsequent injections are not digested 

 in the blood stream but within the cells as before. So that 

 "antianaphylaxis" is dependent on the exhaustion of the 

 excess enzyme in the blood, and the condition is funda- 

 mentally the same as protein immunity, i. e., due to intra- 

 cellular digestion in each case. 



Since complement is used up in anaphylactic shock it may 

 be that the antibody produced is an amboceptor which with 

 complement splits the protein introduced and liberates a 

 poison. Or the using up of complement may be merely 

 incidental. A really satisfactory theory of anaphylactic 

 shock remains to be brought forward. 



As has been indicated, ''serUm sickness" and sudden death 

 following serum injections are probably due to a sensitiza- 

 tion of the individual to the proteins of the horse in some 

 unknown way. Hay fever, urticarial rashes and idiosyn- 

 crasies following the ingestion of certain foods, as strawberries, 

 eggs, oysters, etc., are in most cases anaphylactic phenomena. 



The proper procedure to obtain relief in such cases is to 



