178 ANTI-ANAPHYLACTIC TREATMENT OF DISEASES 



before and behind the stone and prevent it from passing. 

 Morphine or atropine will relieve these pains by relaxing the 

 walls of the canal so that the stone continues on its way 

 without causing the slightest harm. The primary cause of 

 the evil here is therefore the formation of the stone and its 

 entry into the canal. It is likewise the stone which prepares 

 the traumatic lesion of the walls of the canal, but it is the 

 reflex reaction of the nerve centers which maintains the lesion 

 and the pain. To abolish the sensitiveness of the nerve 

 centers is to end the contractions and the pain. 



In the same order of ideas, an anaphylactic state is created 

 by preparatory injections of an antigen, and a fatal crisis 

 is precipitated by the second injection of the same antigen, 

 but this crisis can be avoided by the absorption of a suffi- 

 cient dose of alcohol or ether (Roux and Besredka), or also 

 by an injection of adrenalin (Milian). Here the primary, 

 initial cause of the pathologic state is .the preparatory injec- 

 tion of the antigen which causes the formation of the anti- 

 body by certain cells. The resulting lesion is localized in 

 these cells; there is no symptom. The anaphylactic crisis 

 is caused by the action on the nerve centers of the precipi- 

 tate which results from the combination in the blood of the 

 excess antibody with the antigen of the second injection, 

 suddenly disturbing the general nutritive equilibrium and 

 more especially that of the nerve centers. A sufficient dose 

 of alcohol or ether anesthetizes the nerve centers, while 

 adrenalin contracts the capillaries and prevents the precipi- 

 tate from reacting in them. 



As in the case of stone, so in the case of the antigen, it is 

 through the nerve centers that the pathologic manifestations 

 may be relieved or prevented. 



It is interesting to quote here, on this subject, an accurate 

 experiment of E. C. Kendall, inspired by the work of Crile 

 on the role of the suprarenal capsules in Barlow's disease. 

 This experiment as reviewed in the Presse Medicale 1 deserves 

 to be quoted in toto: 



"Operating on dogs, Kendall slowly injected intravenously 



1 Kendall, Edward C.: Experimental Hyperthyroidism, Jour. Am. Med. 

 Assn., lix, 612. From the Presse Medicale, 1917, No. 59, p. 612. 



