244 THE PRINCIPLES OF IMMUNOLOGY 



vaccinia." This description indicates the changes that may appear fol- 

 lowing an uninfected vaccination with smallpox virus. There appar- 

 ently occurs, following smallpox and vaccinia, an altered state which 

 determines these local reactions, but the interpretation offered by Force 

 that some of these reactions are immune reactions still lacks satis- 

 factory confirmation and is not consistent with other studies of 

 cutaneous reactions (see page 237). 



Cutaneous Reactions in Glanders. The Mallein test devised by 

 Kelmann and Kelming is widely employed in veterinary practice, either 

 in the form of subcutaneous injection which produces a general reaction 

 as is the case with tuberculin, or in the form of conjunctiva! test which 

 produces local and often general reactions. 



Other Cutaneous Reactions. As can very well be understood the 

 encouraging results with such a large number of skin reactions has 

 led to the investigation of similar tests in other diseases and the reac- 

 tion has been applied in leprosy, sporotrichosis, hyphomycetes infec- 

 tions, pregnancy, canine distemper and numerous other conditions. 

 The Schick test for diphtheria is not to be included among the skin 

 reactions indicating hypersusceptibility, for, as has been shown pre- 

 viously, this test depends upon the presence or absence of antitoxin in 

 the circulating fluids of the body. 



