150 



ANAPHYLAXIS IN ITS RELATION TO DISEASE 



But, whereas the injection of horse serum does not necessarily give 

 rise to any symptoms during this time, since the material that is 

 introduced is sterile, vaccination is early followed by certain local 

 symptoms which we may logically attribute to a multiplication of 

 the organism of cowpox in the skin. This is shown diagrammatically 

 in Fig. 5 in the gradually ascending line representing the first 

 vaccination. We may then suppose that the absorption of some 

 dead organisms (dead when introduced or destroyed by the local 

 defensive forces shortly after their introduction), i. e., of their 

 proteins, is followed after the usual period of about eight days 



-Dcn/s,l 



FIG. 5 

 . ,8 15 .22 



a 



Injection of 

 larger quantity 

 of Vaccine 



Incubation 

 period 



Vaccine 

 disease 



Local Intense local and 

 reaction general reaction 



Diagram illustrating the effect of vaccination in its relation to antibody formation upon the 

 development of the corresponding clinical symptoms. (Taken from v. Pirquet.) 



by the production of the corresponding antibodies, some of which, 

 no doubt, bring about the destruction of all the remaining organ- 

 isms, while others react with the liberated proteins and give rise 

 to anaphylatoxins, which in turn are responsible for the rapidly 

 developing local inflammatory reaction, as also perhaps for some of 

 the systemic symptoms. Theoretically, of course, the anaphy lactic 

 response should continue as long as both antigen and antibody are 

 present, a conclusion with which clinical observation is in perfect 

 accord. It might, of course, be argued that the period of incubation 

 following vaccination was after all due to the multiplication of the 

 variola organisms, and that as soon as this had exceeded a certain 



