HYPERSUSCEPTIBILITY IN MAN 243 



subcutaneous injection of gonococcal vaccine and subsequently pre- 

 pared a glycerol extract of the organism for cutaneous tests. He 

 instituted controls with equal quantities of glycerol and obtained dis- 

 tinctly encouraging results even to the point where one strain of or- 

 ganism produced stronger reactions than other strains. 



Cutaneous Reactions to Meningococcus Infections. Recently Gay 

 and Minaker have employed the intracutaneous reaction for the detec- 

 tion of meningococcus carriers. They prepared a salt solution emulsion 

 of carefully washed and thoroughly dried cultures of five strains of 

 meningococcus and injected 0.000,006 gram of the dried powder in a 

 total volume of 0.05 c.c. They obtained reactions in 64.5 per cent, of 

 known carriers and 26.4 per cent, in individuals known not to be 

 carriers. They do not think that the reaction serves any important 

 purpose in diagnosis but suggest that it may indicate a systemic reaction 

 and possibly a certain degree of acquired resistance to the organism. 



Cutaneous Reactions to Pneumococcus Infections. Earlier in- 

 vestigations with salt-solution extracts were not particularly satis- 

 factory in regard to the early diagnosis of pneumonia, although after 

 the crisis reactions were obtained. Weiss and Kolmer prepared a 

 solution of Type I pneumococci in sodium choleate which they designate 

 pneumotoxin. The test is performed by intracutaneous injection. By 

 careful study of animals, on the basis of both gross and microscopic 

 examination of the site of reaction, as well as of human patients with 

 pneumonia, they obtained distinctly encouraging results during the 

 course of the disease and state that although the test does not seem 

 to be of distinct value in differentiating the type of organism con- 

 cerned, yet it may aid in differential diagnosis between appendicitis, 

 tuberculosis and pneumonia. 



Cutaneous Reactions to Vaccine Virus. Jenner noted that in cer- 

 tain individuals who had previously been vaccinated against smallpox, 

 a second vaccination might produce a local reaction which did not go on 

 to produce vaccinia. This has been observed by numerous investi- 

 gators since then and Force has given the subject close study. For 

 this purpose Force produced three abrasions on the arm, into two of 

 which vaccine virus was rubbed and made observations at the end of 

 twenty-four, forty-eight and seventy-two hours. " If either of the vac- 

 cinated spots showed an areola of 5 mm. or over (with or without 

 papule) at the end of twenty-four hours, which areola (or papule) had 

 decreased at the time of the seventy-two-hour observation, it was con- 

 sidered a reaction of immunity due to the presence in the blood of the 

 individual of antibodies against vaccine virus." " If either of the vac- 

 cinated spots showed an areola at the end of twenty-four hours which 

 developed into a small vesicle, maturing on the fifth or sixth day and 

 then rapidly subsiding the reaction was considered a vaccinoid," a con- 

 dition in which it is supposed antibodies are not present but are rapidly 

 formed because of a previous vaccination, thus leading to the small 

 size and rapid subsidence of the vesicle. " If there was no change until 

 the third day, and then a small areola began to form, the case would be 



