ANAPHYLAXIS 163 



the second injection should be considered as possible subjects for anaphylactic 

 shock. 



Vaughan recommends that when this is to be feared one should only give about 

 o.i c.c. of the serum and after an interval of two hours, provided no untoward symp- 

 toms set in, to give the full amount of the injection. Besredka advises heating the 

 serum to 56 as a guard against anaphylactic shock. 



The condition of hypersusceptibility or anaphylaxis is at times 

 termed allergy. Thus in a person who has been successfully vacci- 

 nated a reaction shows at the site of inoculation within twenty-four 

 hours which does not appear in the nonimmune person for a period two 

 or three times as long. The diagnostic tests with tuberculin and 

 luetin are hence often referred to as allergic reactions. 



It may here be stated that some investigators are of the opinion that 

 our views not only as to immunity but as to the essential nature of 

 infectious diseases may be later on found to rest in production of 

 anaphylaxis. 



The name "Anaphylactine" has been applied to the sensitizing substance pro- 

 duced during the period of incubation. 



It has been proposed to employ this phenomenon as a diagnostic measure. By 

 taking the serum of a tuberculous patient, which would contain the sensitizing sub- 

 stance, and injecting it into the peritoneal cavity of a rabbit, the animal would 

 be sensitized and an injection of tuberculin a few hours later would bring about the 

 phenomena of anaphylaxis in the rabbit. 



This passive anaphylaxis, as it is termed, usually requires approximately twenty- 

 four hours for sensitization. This passive anaphylactic sensitization seems to dis- 

 appear in two weeks. It has been advised to passively sensitize guinea-pigs with 

 the serum of the person about to be injected and then twenty-four hours after inject 

 the guinea-pigs with the curative serum. If untoward results occur in the guinea- 

 pigs the patient should not receive the injection. 



Recently Hagemann has found the following technic valuable in the diagnosis 

 of surgical tuberculosis. Guinea-pigs are inoculated intraperitoneally with tuber- 

 culosis cultures and by the end of the second week such pigs are sensitized. The 

 suspected material, as serous effusion, is injected intracutaneously and within 

 twenty-four to forty-eight hours a distinct swelling of the skin with a bluish-red 

 center, which is surrounded by a porcelain white ring and outside of this a zone 

 of inflammation, shows a positive test. 



