ANAPHYLAXIS 89 



takes place a series of phenomena always the same, which 

 constitutes anaphylactic shock." 



Besredka does not explain either by physical or by chemi- 

 cal means or by both together the affinities and combina- 

 tions which he considers take part in the reaction, but the 

 apparent contradiction expressed in the two phrases which 

 precede may be explained with a little latitude. The affin- 

 ities are very probably chemical in nature and the combi- 

 nations as well; but in Besredka's conception the product 

 formed by the combination does not act by its chemical 

 properties (poison), but only by its physical properties 

 (precipitate). It is not the product already formed which 

 causes the pathologic manifestations of the anaphylactic 

 state, but only the rapidity with which products are formed ; 

 in his opinion, precipitates are not necessary. 



Thus, in the last analysis whether a precipitate is formed 

 or not, the experiments of Besredka and the intrepretations 

 which he himself puts on them indicate that it is the factor 

 time which is at least one of the conditions of the reaction, 

 and may be the single cause of anaphylactic shock. (This 

 one factor ought, we think, to be chemical or rather physico- 

 chemical since the reaction concerns colloids.) 



F. G. Xovy and P. H. de Kruif 1 return again in an exten- 

 sive work which has just appeared, to the idea of a soluble 

 anaphylatoxin or "taraxin" formed in the organism by a 

 substance "taraxigen." Anaphylactic shock would be the 

 result of a sort of tautometric intramolecular rearrangement 

 of certain very labile substances contained in the blood. 



Fundamentally it is evident that all these different ideas 

 are only plays on words. There has been, and is, much 

 discussion in current chemical literature on the subject of 

 the different phenomena and processes surrounding immun- 

 ity and anaphylaxis just as our fathers and grandfathers 

 discussed symptoms, pathogenicity and evolution of infec- 

 tious diseases before the discovery of bacteria, and in order 

 to explain these things there has been created a complicated 

 and barbarous terminology which has incidentally the great 



1 Anaphylatoxin and Anaphylaxis, Jour. Am. Med. Assn., May 26, 1917. 



