ANAPHYLAXIS OR HYPERSUSCEPTIBILITY 301 



THEORIES CONCERNING ANAPHYLAXI& 



A number of theories of anaphylaxis have been advanced which de- 

 serve serious consideration, since they are experimentally supported 

 and may serve as points of departure for future research. 



One of the earliest ideas was based on the Ehrlich theory of re- 

 ceptor overproduction by tissue cells during immunization. It was 

 suggested that hypersusceptibility might be due to stimulation of new 

 specific receptors which as yet remained sessile upon the cells instead 

 of having been thrown off into the blood stream. As a consequence, 

 the cells, having affinity for more of the toxic substance of the antigen 

 than they had normally, are more vulnerable. 



v. Pirquet and Schick, 1 as well as many other observers, have re- 

 garded the anaphylactic process as analogous to other immune reactions, 

 and believe that an antigen in the serum first injected produces a specific 

 antibody. The reaction between these two substances following the 

 second injection gives rise to the anaphylactic symptoms. The essen- 

 tial feature of this opinion is the assumption that the substance which 

 sensitizes after the first injection is identical with that which exerts the 

 anaphylactic injury after reinjection. 



Wolff-Eisner 2 has expressed a belief which has found much experi- 

 mental support in the hands of Vaughan and Wheeler. 2 Wolff-Eisner 

 holds that all cells and proteins contain a toxic substance which is 

 characterized by its inability to produce a neutralizing antibody when 

 injected into animals. The first injection produces a lysin for the pro- 

 teid injected, which possesses the power of liberating such poisons from 

 the complex molecule. A second injection is followed, consequently, 

 by a rapid liberation of the toxic fraction, and injury to the animal 

 results. This view has been expressed in slightly different form by 

 Richet 3 and has been more clearly formulated and experimentally sup- 

 ported by Vaughan and Wheeler 4 who were actually able to extract 

 from various proteins toxic substances which gave rise in animals to a 

 symptom complex not unlike that of typical anaphylaxis. (Extraction 

 with alkalinized seventy-per-cent alcohol.) 



The earlier theories of Gay and Southard 5 and that of Besredka 6 



1 v. Pirquet und Schick, loc. cit. 2 Wolff-Eisner, Berl. klin. Woch., 1904. 



3 Richet, Ann. de Tlnst. Pasteur, xxi, 1907. 



4 Vaughan and Wheeler, Jour. Infect. Dis., iv, 1907. 



6 Gay and Southard, Jour. Med. Research, 1907, xvi. 



6 Besredka, Bull, de 1'Inst. Pasteur, 1908, vi, 826. 



