PATHOGENESIS 295 



"It is possible by intercurrent injections to prevent the 

 appearance of the anaphylactic state" " anti-anaphylaxis." 



I should say, however, that the appearances are that this 

 case merely amounts to a suppression of a particular form of 

 symbiotic reaction against foreign matter, not to a real cure. 

 We shall see later that Prof. Richet himself apprehends that 

 frequently only a suppression of symptoms takes place. The 

 probability of a similar conversion of certain wide-spread 

 diseases into others has indeed occupied some of the more 

 thoughtful amongst medical men. 



" There is a form of anaphylaxis termed passive; that is to 

 say, the blood of anaphylactised animals injected into normal 

 animals produces anaphylaxis in them after a large number of 

 injections, occasionally after a single primary injection." 



What has the blood of one animal and in particular of a 

 poisoned one to do in the veins of another? Is it surprising 

 that the direct introduction of poisons into the blood or the 

 spinal canal, thus escaping the safeguarding effects of the 

 digestive process, should in effect amount to an artificial pro- 

 duction of disease against which the body must constantly and 

 vigorously react? 



"In Paris alone, at a short interval of time, ten deaths 

 have occurred which can be put down simply to injection of the 

 serum into the spinal canal. These cases will multiply if a 

 remedy is not found." (Lancet, 16/8/13.) 



NOTE. Thus we see from clinical evidence how the blood is "ammonisized " by 

 perpetual in-feeding and impaired in resisting power. The " soil " may well be more 

 important than the germ. In the case of wounds, when progressive necrosis of cells 

 occurs, it is not known to what an extent this is due to the direct action of specific 

 toxins secreted by bacilli or to the action of injurkrns by-products formed in the 

 decomposition of tissues already invaded by the bacilli. For instance amongst the 

 by-products formed in the tissues is sulphuretted hydrogen which itself destroys 

 red blood cells by its action on the iron of the heemoglobm. (A. G. B. Foullerton, 

 F.R.C.S.) The conclusion is thus again forced upon us that it is precisely a previous 

 intoxication of the blood by habitual ingestion of animal proteids which offers the 

 conditions favourable to virulence of microbic invasion (as in the case of the colon 

 bacillus, the ally of senility) be it through ordinary infection or in the case of pro- 

 gressive necrosis from wounds. Similarly it remains to be seen to what an extent 

 " wound "-fever is really " protein "-fever. The degree of dietetic protein-intoxication 

 must largely determine the toxigenic production of fever in any distress of the body. 

 The injurious effects of habitual in-feeding thus become specially emphatic on a 

 break-down when the previous harmony of the heat-producing, heat-distributing 

 and hcat-restrainine apparatuses is inhibited and an increased metabolism in the 

 exposed tissues is indicated. The latter now easily become over-dosed with " com- 

 bustible" proteid material and a general hyperthermia may ensue. Infection, 

 toxigenesis. and hyperthermia may now easily become allies of progressive necrosis 

 or of pathogenesis. We saw in the case of the " increased sensitivity " of Prof. 

 Richet's dog, rendered annemic through bleeding, how susceptibility and reaction 

 may become acute under similar predicaments. 



