ANAPHYLAXI& IN ITS RELATION TO DISEASE 



161 



future studies of these diseases from this standpoint will, no doubt, 

 lead to interesting results. All along the line a start has indeed only 

 now been made, and a great deal remains to be done, but I believe 

 that there is scarcely any field of study, which from the standpoint 

 of the clinician promises such fruitful returns, as the investigation 

 of our common infectious diseases and their pathogenic agents along 

 these lines. 



Days ,1 



FIG. 10 



,8 15 22 



i i i i i i i i i i i i i i i i . i . i i i t 



Autoreinfection 



Threshold of 

 Clinical 

 anifestations 



Sequela 



Diagram illustrating the interaction between antigens and antibodies in their relation to the 

 clinical picture and a sequela of scarlatina. (Taken from v. Pirquet.) 



At the present state of our knowledge it is, of course, very diffi- 

 cult to decide which symptoms in a given disease are due to bacterial 

 toxins, which to endotoxins, which to ptomains, and which to anaphyl- 

 atoxins; but it is important to recognize that with the discovery of 

 the latter a new vista has been opened up, along which we can see 

 the possible manner in which some of those organisms may produce 

 symptoms of disease and even death, which are recognizedly not 

 toxin producers, and whose endotoxins also are not sufficiently active 

 to cause the clinically recognizable results of infection. This is 

 indeed a most attractive field for speculation, but as a further 

 discussion of the many possibilities and problems which suggest 

 themselves in this connection would of necessity be purely 

 theoretical in character, it will be better to leave this to some 

 future occasion, when actual experimental data may be at our 

 disposal. 

 11 



