as high as 105 and be accompanied by any or all the above symptoms. 

 The occurrence of these reactions is quite common and in a series of 280 

 transfusions described by Meleney, Stearns, Fortuine and Ferry they 

 were present in 63.6 per cent, varying in degree, but always being evi- 

 denced by a rise of temperature to 100 or more. In this series, the 

 method of transfusion, blood relationship of donor and recipient, and 

 the blood group of the recipient seemed to have nothing to do with the oc- 

 currence of the reaction. It seemed that reactions were more common 

 after large transfusions and that the blood of some donors was more likely 

 to cause reaction than the blood of others. In some cases the post-trans- 

 fusion reaction was accompanied by marked polymorphonuclear leuko- 

 cytosis. These in general are the findings of most observers who have 

 studied post-transfusion reactions and by many it has been thought that 

 these reactions depend upon the formation of some toxic material from 

 the partial splitting of protein, though there is no direct evidence to 

 demonstrate the truth of this conclusion. 



Since the investigation upon salt fever, salvarsan reactions and the 

 blood transfusion reactions, somewhat similar reactions have become 

 familiar after the injection of many materials both rich in protein and 

 poor in this substance. Similar immediate reactions are not uncommon 

 after the administration of large doses of serum such as that employed 

 in the treatment of pneumonia due to pneumococcus Group I, while re- 

 actions accompanying intravenous administration of bacterial vaccine, 

 milk and other forms of protein, for therapeutic purposes are now thor- 

 oughly familiar. This intravenous vaccine or so-called protein non-spe- 

 cific therapy, employed first by Ishikawa and Gay in the specific treat- 

 ment of typhoid fever with typhoid vaccines, and later by Nolf, Miller 

 and Lusk(a) (e?) (e), and Cowie and Calhoun and others in the treatment 

 of arthritis of various forms, is regularly followed by a marked reaction 

 very similar to that already described but particularly noteworthy for the 

 rapid rise and subsequent fall in temperature. As has been shown by 

 Cowie and Calhoun and further by Gow the reaction is characterized by a 

 marked change in the total number of leukocytes ; this consists first, in a 

 leukopenia followed by a more or less pronounced polymorphonuclear 

 leukocytosis. There are, however, many features of these reactions which 

 are very imperfectly understood, and, except that they are associated with 

 the injection of foreign protein in some form, we are at present ignorant 

 as to the exact substance which brings them about. In many respects they 

 resemble the reactions brought about in guinea-pigs by the injection into 

 the veins of such substances as kaolin, agar-agar, etc. 



There are finally a few observations upon the effect of at least one 

 toxic diamin, namely, histamin in man. It was- shown in 1913 by Ep- 

 pinger and Guttmann that histamin when rubbed into the skin of the nor- 

 mal individual produces an urticarial wheal. A more recent study of 



