IDIOSYNCRASIES 579 



strychnin, morphin, etc., appear to develop a state of hypersensitive- 

 ness. Klausner was able passively to sensitize guinea-pigs against 

 iodoform by injecting the serum of a person sensitive to this drug. 

 Examples of drug anaphylaxis or idiosyncrasy are more difficult to ex- 

 plain unless such drugs contain a protein substance. On the other hand, 

 a drug may alter a body protein, rendering it really a foreign protein, 

 and this may sensitize body-cells in the same manner as in the "indirect 

 anaphylaxis" of Richet, referred to in the preceding chapter, following 

 the second chloroforming of a dog. 



As was previously stated, anaphylaxis, or rather the anaphylactic 

 mechanism, may be considered one of the essential steps in affording 

 resistance to disease or the state of immunity. Broadly speaking, the 

 lesions and symptoms of infection may be ascribed to the effects of 

 soluble toxins, endotoxins, and a protein poison. According to our 

 present knowledge, the endotoxins are mainly liberated with lysis or 

 disrupture of the bacterial cell. Similarly the protein poison is pro- 

 duced by cleavage of the bacterial protein substance. Whether the 

 endotoxins and protein poison are identical it is impossible to state. 

 For the present it may be well to consider them as separate entities. 

 In certain infections, such as tetanus and diphtheria, the soluble toxins 

 are chiefly concerned, and these are neutralized by specific antibodies, 

 the antitoxins. The antitoxins are not similar to the " ferment" that 

 splits protein, because they are able to neutralize their toxins without 

 the aid of complement. In other infections, such as typhoid fever, 

 cholera, and pneumonia, the endotoxins and protein poison may be con- 

 sidered the main etiologic factors. The chief antibodies are a cytolysin 

 (bacteriolysin), which disrupts or kills the bacterial cells, and bacterio- 

 tropin, which brings about the same result by favoring phagocytosis. 

 Lpparently the cytolysins and the so-called "ferments" responsible for 

 cleaving the protein substance are quite similar in their mechanism. 

 The former are amboceptors, thermostabile and inactive without the 

 presence of a complement. There is no doubt but that heating a serum 

 containing a bacteriolysin and a complement will render the serum in- 

 active through destruction of the complement. While the ferment con- 

 cerned in splitting protein is regarded by many as an amboceptor and 

 complement, there is no general agreement on this point. Some in- 

 vestigators, for example, believe that the ferment concerned in splitting 

 placental protein, as in Abderhalden's pregnancy reaction, is rendered 

 totally inactive by heating the serum. Others believe that heating 

 diminishes the activity of the ferment, but does not destroy it altogether; 



