ANAPHYLAXIS 65 



that the first injection directly sensitizes important cells which are 

 destroyed when an intoxicating dose arrives. 



The similarity of characters between serum shock and immedi- 

 ate traumatic shock was thought to shed some light on the sub- 

 ject. The latter is believed to be due to protein degradation 

 products, due to trauma or low blood pressure, which have a 

 paralyzing effect upon unstriped muscle or upon the vasomotor 

 centers. 



It has been shown that an anti-anaphylactic state can be pro- 

 duced by repeated small injections of protein at intervals too 

 short to allow incubation of an intoxicating dose. Use is made 

 of this knowledge in the case of persons who need anti-serum but 

 who show sensitivity to it. Repeated small but increasing quan- 

 tities are put into or under the skin or into the vein until the 

 patient can receive without reaction the full dose. This is called 

 desensitization. 



Friedberger has used these facts to elaborate a theory of infec- 

 tion. He believes that bacteria circulating in the body stimulate 

 anti-bodies, combine with them and that when complement acts 

 upon this union toxic substances are set free. 



In explaining all infectious diseases on this basis one assumes 

 that sometime in life a person has been sensitized by bacteria or 

 their proteins so that he is receptive for a virulent germ when 

 this has overcome the primary external bodily defenses. It is also 

 to be considered the modern explanation of diathesis. 



McKail divides anaphylaxis as follows: 



Natural Anaphylaxis, depending upon 



(a) Species of animal, for example cholera in man, anthrax 



in cattle, glanders in horses. 



() Age diphtheria in children, erysipelas in the elderly. 

 (c) Individual to white of egg, or blood serum, even by in- 



gestion ("one man's meat is another man's poison"), 



5 



