340 PROTEIN POISONS 



washed typhoid bacteria are not entirely due to preformed 

 secretory toxic bodies that are stored in the bacterial bodies, 

 but that these properties are due largely to products formed 

 by hydration of the bacterial proteins through the agency 

 of ferments present in the circulation of the animal previous 

 to the injection, or which become mobile subsequent to 

 the entrance of the foreign bodies into the blood-stream. 

 Since leukocytic ferments can attack the bacterial proteins 

 in vitro, it is possible that the leukocytes are a source of the 

 ferments which are active in experimental and natural cases 

 of intoxication with the whole bacteria." 



Nolf 1 has stated a theory of anaphylaxis which has come 

 to be known as "the physical theory." It supposes that 

 the active constituent of proteins is a thromboplastic sub- 

 stance which disturbs the colloidal equilibrium of the blood 

 and leads to the deposition on the surfaces of the leukocytes 

 and the endothelial cells of capillaries, of a delicate film of 

 fibrin. Thus stimulated, these cells pour out an unusual 

 amount of antithrombin. On account of the consumption 

 of a part of the fibrinogen and the increased formation of 

 antithrombin the blood fails to coagulate after anaphylactic 

 shock or peptone poisoning. On account of the coagulation 

 deposits on the endothelial cells the viscosity is increased 

 and the leukocytes adhere to the vessel walls, thus accounting 

 for the leukopenia observed after protein injections. The 

 endothelial cells are injured and the walls of the capillaries 

 become more permeable, thus accounting for the local edema 

 often seen in anaphylaxis. The fine capillaries of a given area 

 may be occluded by thrombi, and this explains the necrosis 

 characteristic of the Arthus phenomenon. The irritation 

 of the endothelial cells extends to the smooth muscle, and 

 this leads to vasoparalysis, and the characteristic fall in 

 blood-pressure. The affinity of the endothelial cells for 

 the protein is stimulated by the first injection, and acts in 

 a fulminating way on reinjection, and thus the suddenness 

 of anaphylactic shock is explained. 



1 Archiv. intern, de physiol., 1910. 



