162 ANAPHYLAXIS IN ITS RELATION TO DISEASE 



Idiosyncrasies and Anaphylaxis. I have pointed out above that the 

 development of a definite symptom-complex following the parenteral 

 introduction of horse serum (i. e., of alien albumin) suggests the possi- 

 bility that some of the non-infectious diseases with which we have 

 long been familiar may possibly be due to similar causes. Recent 

 investigations have shown that such is actually the case, and with 

 the recognition of this possibility an unexpected ray of light has 

 reached one of the darkest corners of our clinical rubbish room 

 where have reposed for centuries the time-honored and mystic 

 " idiosyncrasies.' ' 



Especially interesting in this connection are the observations which 

 have been made in the so-called "hay fever" or pollen disease, as it 

 would be more appropriate to term the malady. As is well known, 

 certain individuals are annually attacked with irritation of the 

 mucosa of the nose, giving rise to paroxysms of sneezing, and later 

 with a similar irritability of the pharynx and the trachea, leading to 

 asthmatic disturbances of greater or less severity. The occurrence 

 of these attacks is intimately associated with the time of the year at 

 which certain plants (belonging to the orders of the Graminese, also 

 Ambrosia and Solidago) come into blossom, and is due, as Elliothson 

 already pointed out in 1831, to the absorption of some constituent 

 of the pollen of the respective plants. Weichardt and Wolff-Eisner 

 then pointed out (1905 and 1906) the close similarity between 

 the symptom-complex in question and the serum sickness of v. 

 Pirquet and Schick, and suggested that it also could readily be 

 explained upon the basis of anaphylaxis. As a matter of fact it is 

 possible in a susceptible individual to call forth a typical attack at any 

 time either by the introduction of a suspension of the corresponding 

 pollen into the conjunctiva, or by its subcutaneous application, in 

 a manner quite analogous to the tuberculin test. Here as there 

 the amount of material which will suffice to bring about a reaction 

 is remarkably small. Wolff-Eisner thus reports that a typical 

 response will follow the application of but two drops of a 0.2 per 

 cent, solution of pollen, and Lubbert mentions that in highly sus- 

 ceptible individuals even TOTO o" milligram may produce symptoms. 



Closely related to pollen fever are no doubt also those curious 

 asthmatic conditions which have been noted in some individuals follow- 

 ing the inhalation of Witte peptone, after the ingestion of egg albumin, 

 strawberries, blueberries, gooseberries, various leguminous vegetables, 



