CHAPTER XI 

 HYPERSUSCEPTIBILITY IN MAN 



INTRODUCTION. 



SERUM DISEASE. 



THE DELAYED REACTION. 

 THE ACCELERATED REACTION. 

 ANAPHYLACTIC SHOCK IN MAN. 

 NATURAL HYPERSUSCEPTIBILITY. 



TESTS FOR HYPERSUSCEPTIBILITY. 



TOXINS IN HAY FEVER. 

 TECHNIC OF CUTANEOUS TESTS. 

 DELICACY OF TESTS. 

 THE REACTION. 



THEORIES OF CUTANEOUS REACTION. 

 DRUG IDIOSYNCRASIES. 

 THE TUBERCULIN TEST. 



GENERAL REACTION. 

 CUTANEOUS REACTION. 

 INTRACUTANEOUS TEST. 

 CONJUNCTIVAL TEST. 

 THEORIES OF TUBERCULIN TEST. 

 SPECIFICITY. 

 UTILITY. 



THE LUETIN REACTION. 



CUTANEOUS REACTIONS IN TYPHOID FEVER. 

 CUTANEOUS REACTIONS IN GONOCOCCUS INFECTIONS. 

 CUTANEOUS REACTIONS IN MENINGOCOCCUS INFECTIONS. 

 CUTANEOUS REACTIONS IN PNEUMOCOCCUS INFECTIONS. 

 CUTANEOUS REACTIONS TO VACCINE VIRUS. 

 CUTANEOUS REACTIONS IN GLANDERS. 

 OTHER CUTANEOUS REACTIONS. 



Introduction. The manifestations of hypersusceptibility in man 

 can be classified into two groups, those in which a definite previous sensi- 

 tization has been effected and those in which no such sensitization is 

 known or can be conclusively proven. In the former group are 

 included a relatively few cases of anaphylactic shock and the widely- 

 observed phenomenon called serum disease. In the latter group are 

 those individuals who are abnormally sensitive to a wide variety of sub- 

 stances. These may gain access to the body from the air, through the 

 respiratory tract, skin or conjunctiva or through ingestion of foods 

 which contain the specific substance. In addition to air contacts, direct 

 contacts with plants and animals, which may or may not serve to produce 

 dusts, may also lead to dermal manifestations of hypersenstiveness. 



Serum Disease. The Delayed Reaction. The serum treatment of 

 various diseases has given ample opportunity for the study of the 

 symptom complex called by von Pirquet and Schick serum disease. 

 This follows with extreme frequency upon subcutaneous, intravenous or 

 intrathecal injections of animal sera employed for therapeutic pur- 

 poses and may be delayed or accelerated. The symptoms may develop 

 after a primary or series of primary injections and constitute the delayed 

 reaction. These symptoms appear from six to twelve days after the 

 228 



