224 ANAPHYLAXIS 



An animal that recovers from the second injection becomes 



Anana- immune to further administration of the same proteid. This 



phylaxis. non-susceptible condition has been wrongly termed antiana- 



phylaxis. It is much more reasonable to speak of "anana- 

 phylaxis," since the absence of hypersensitiveness is not due to the neu- 

 tralization of the bodies necessary for bringing about the hypersuscepti- 

 bility. The ananaphylactic state sets in as early as two hours after 

 the anaphylactic outburst. 



In order to prevent the shock of anaphylaxis, it has been suggested by 

 Besredka and Steinhardt to give the second injection during the period of 

 incubation, i.e.) about the eighth day, or give a very minute dose of serum 

 at the regular time of the second inoculation and give the larger dose in 

 24 hours. 



Just as an immunity may be transmitted by injecting the serum 



Passive obtained from an immune animal, so also can the tendency 



Anaphylaxis. to hypersusceptibility be transmitted by introducing into a 



normal animal the serum from a sensitized one, i.e., one that 

 has been injected with a foreign proteid. This is best demonstrated by 

 injecting the anaphylactic serum subcutaneously, followed in 24 hours 

 by the intravenous inoculation of the respective antigen. 



A fully satisfactory explanation for all the phenomena of 

 Theories anaphylaxis has not as yet been advanced. Certain it is 

 of Anaphy- that a number of underlying factors exist which bring ana- 

 laxis. phylaxis and immunity into close relationship. 



Since the term immunization usually implies a beneficial 

 process, while anaphylaxis in most instances represents a situation of an 

 injurious nature, v. Pirquet recommended the term " allergic" to designate 

 the reactive changes which an organism generally exhibits after infection 

 or injection of an antigen. The allergic phenomena are divided into 

 those associated with diminished susceptibility, i.e., prophylaxis, and those 

 with increased sensitiveness, i.e., anaphylaxis. 



Besredka adheres to the view that the anaphylactic syndrome expresses an insult to 

 the central nervous system. He was able to show that susceptible guinea-pigs, when 

 etherized, will bear the second inoculation of the serum perfectly well. V. Pirquet and 

 Schick consider the precipitin action as the basis for the anaphylactic phenomena. In 

 the main, however, there are two theories, a cellular and a humoral one. The former 

 suggests that the hypersusceptibility is due to the stimulation of new specific receptors 

 which remain sessile, i.e., attached to the body cells instead of being thrown off into 

 the blood stream. When more antigen is injected, these cells, due to their greater 

 affinity, absorb more of the toxic substance of the antigen than they do normally, and 

 thus the anaphylactic shock is incited. 



The humoral theory represents the main activity within the serum. This hy- 

 pothesis was adopted by Wolff-Eisner, a pupil of Pf eiffer, and was based upon Pfeiffer's 

 endotoxin principle. It takes for granted that all antigens, cells and proteids, contain 



