584 ANAPHYLAXIS 



from the toxin elaborated by the same microorganism, results that were 

 confirmed in 1911 by Friedberger and Reiter, 1 working with the dysen- 

 tery bacillus. Thus hypersensitiveness to toxins is probably not an 

 anaphylactic phenomenon, but is due to a greater affinity of the body- 

 cells for the toxin. This explains the so-called paradox of Kretz, who 

 found that while the injection of an accurately neutralized toxin-anti- 

 toxin mixture produces no bad results in a normal animal, in one that 

 has been previously actively immunized with toxin, the reverse occurs. 

 Apparently the sessile receptors have a stronger affinity for toxin than 

 have the free receptors, and accordingly the toxin becomes dissociated 

 and combines with the cells. 



This view is also substantiated by the observation that the symptoms 

 of intoxication caused by the toxin used for immunization are not those 

 of anaphylaxis, which, for a certain animal, are the same regardless of 

 the source of the protein. Toxin hypersensitiveness does not seem to 

 be transmissible to normal animals, whereas in anaphylaxis the condi- 

 tion may be transmitted (passive anaphylaxis). 



Whether or not endotoxins act as anaphylactogens cannot be definitely 

 stated. If they do, their action and effects are intimately connected 

 with those ascribed to the protein contained in the bacterial cell. It is 

 unlikely, however, that they play any role in inducing hypersuscepti- 

 bility, as their toxicity is usually apparent soon after injection, and 

 before sensitization has occurred. 



The necessary period of incubation between sensitization and in- 

 toxication, the symptoms, and the fact that in some cases an immunity 

 is induced, are results that strengthen the belief that the phenomenon of 

 hypersensitiveness has a practical significance in the prevention and cure 

 of certain infectious diseases. 



THE HUMORAL OR ANAPHYLATOXIN THEORIES OF ANAPHYLAXIS 



The symptoms of anaphylaxis that follow injection of the protein 

 into an animal previously sensitized with the same protein have been 

 ascribed to the effects of a poison as the etiologic factor, although as yet 

 this poison has not been isolated in a pure state. 



The Anaphylatoxin or Protein Poison. Vaughan and Wheeler 

 were the first to demonstrate a poison in vitro by splitting proteins with 

 a solution of NaOH in absolute alcohol. Friedmann was first to pro- 

 duce it in vitro through the action of ferments contained in immune 

 and normal rabbit serum upon ox corpuscles and serum precipitates. 

 1 Zeitschr. f. Immunitatsf., 1911, 11, 493. 



