246 PROTEIN POISONS 



and the animal having reached this stage, usually dies in a 

 convulsion or immediately following one. Expulsion of 

 urine and feces is frequent in the convulsive stage. Recovery 

 after reaching the convulsive stage is exceedingly rare. 

 When this stage is not reached, recovery usually occurs, 

 and is so prompt and complete that after a few hours, or 

 at most by the next day, the animal cannot be distin- 

 guished from its perfectly healthy fellows. 



This is an exact reproduction of the picture of poisoning 

 an untreated guinea-pig with the protein poison of Vaughan 

 and Wheeler, and another indication that this and the 

 anaphylactic poison are one and the same. 



In dogs the first two stages, as seen in the guinea-pig, 

 occur with some variations. The first stage is one of excite- 

 ment. The animal moves about uneasily and cries. He 

 retches and sometimes vomits. Expulsion of urine and 

 feces frequently occurs. In the second stage, one of 

 great muscular weakness, he lies flat on his side or belly, 

 with his head on the table. When placed on his feet he 

 stumbles, falls, and lies with extended legs, as if paralyzed. 

 There may be marked expiratory spasms with retching, 

 and repeated expulsion of feces. There is finally suppres- 

 sion of urine. The animal remains in this state of depression 

 for many hours, and then dies or slowly and completely 

 recovers, so that the next day it seems as well as ever. 

 Again, this is a duplication of the poisoning produced in an 

 untreated dog with the protein poison. 



Acute anaphylactic shock is seen in men being treated 

 with sera or other albuminous fluids. We saw it repeatedly 

 some years ago when we treated tuberculosis with yeast 

 nuclein, and the tuberculin reaction is one of sensitization. 

 It is not our purpose to go into detail concerning the ana- 

 phylactic phases seen in man under various conditions. 

 That part of our subject will be dealt with later. At 

 present we are to speak only of acute anaphylactic shock in 

 man. When the homologous protein is injected into a man 

 sensitized by disease or by previous treatments, symptoms 

 develop promptly, often within a few minutes, usually 



