226 ANAPHYLAXIS 



Friedberger demonstrated that a toxic product which he named "Ana- 

 phylatoxin" can be obtained in vitro from every proteid, be it animal or 

 bacterial in nature. His technique is almost identical with that of Friede- 

 mann described above. 



Accordingly, Friedberger proposed a theory explaining the course and 

 nature of all infectious diseases upon the basis of such a common anaphy- 

 latoxin, independent of the character and virulence of the bacteria. 

 While this hypothesis takes into consideration the older belief that disease 

 is due to a struggle between the infectious agent and the invaded organism, 

 it does so in a somewhat broader sense. From Friedberger's standpoint 

 it is the unspecific anaphylatoxin which is the important factor; its vari- 

 able quantity, which stands in direct association with the variable pro- 

 portions of antigen, amboceptor and complement, accounts for the 

 various pictures of the different bacterial infections. 



This explanation hardly suffices for all the characteristic symptoms of 

 the infectious diseases. It does, however, account for one, the fever. 



That some relationship exists between hypersusceptibility and the 

 thermal center was first observed by H. Pfeiffer and Mita. The ana- 

 phylactic shock is always associated with a fall in temperature, and at 

 times this may be its only manifestation. 



A different effect upon the temperature results according to the dif- 

 ferent quantity of anaphylatoxin injected (Schittenhelm and Weichardt, 

 Friedberger and Mita). Well-defined limits have been established. 



Aside from the effect upon the temperature, other characteristic 

 phenomena of the anaphylactic intoxication are the incoagulability 

 of the blood and the marked distention of the lungs as found by post 

 mortem examination. 



The symptoms of active anaphylaxis differ in the various ani- 



Serum mals. In man very exact studies of the results of the repeated 



Disease, injections of foreign serum have been made by V. Pirquet and 



Schick. 



The evidences of serum sickness are numerous. Those which are pres- 

 ent most frequently are fever, skin eruptions, swelling of the joints, glan- 

 dular enlargement and edema. 



These symptoms may follow even the very first injection of serum. As 

 a rule they develop after an incubation period of eight to ten days. Slight 

 reddening at the point of injection accompanied by moderate swelling of 

 the regional lymph glands appear as prodromal manifestations. 



The general condition of the patient is generally only very little dis- 

 turbed in spite of the frequently associated high fever. Still there are 

 instances, especially after the introduction of large amounts of serum, 

 where the symptoms continue for about four to five weeks and then lead to 

 severe disturbances. 



