614 ANAPHYLAXIS IN RELATION TO INFECTION AND IMMUNITY 



Friedberger and Mita have advocated the slow intravenous infusion of 

 serum a drop at a time. 



The Treatment of Serum Disease. In the majority of instances no 

 treatment is necessary. Calcium chlorid and lactate, in doses of from 

 3 to 5 grains, have been advocated as a prophylactic and as a cure, but 

 they are of doubtful utility. Soothing lotions, a brisk cathartic, and 

 sedatives are indicated, and occasionally an opiate is advisable. The 

 administration of adrenalin chlorid by subcutaneous injections frequently 

 affords quick relief; as its effects are of short duration, repeated doses 

 may be necessary until the urticarial rash has subsided. 



In the rare acute attacks marked by extreme dyspnea or rapid and 

 shallow breathing with rapid and feeble pulse, atropin and caffein should 

 be administered hypodermically. 



IDIOSYNCRASIES 



Studies in anaphylaxis have also offered an explanation of many, if 

 not of all, of those peculiar instances in which the inhalation of some 

 animal effluvium or of the pollen of certain plants or the ingestion of 

 certain food-stuffs and drugs is followed by a train of symptoms, among 

 which asthma and an urticarial rash are usually quite prominent. 

 Hitherto these manifestations have not been understood, and were 

 simply classed as idiosyncrasies a term that is correct if we can make it 

 mean hyper sensitiveness, for experimental investigation leaves little 

 doubt but that in these persons antibodies for the substances in question 

 are present in the body cells and fluids which with the particular protein 

 when it gains access to the body produces the anaphylactic reaction 

 responsible for the symptoms. One remarkable feature of these instances 

 of idiosyncrasy, however, is the extreme hypersensitiveness of the body- 

 cells, especially in those cases where the inhalation of such infinitesimal 

 quantities of protein as are contained in the air will bring on a typical 

 asthmatic attack in a person hypersensitive to horse protein. 



Examples of idiosyncrasy are relatively common. Susceptible per- 

 sons learn to know that the ingestion of this or that substance is sure to 

 be followed by various distressing symptoms. How and when these 

 persons became hypersensitive are usually not known. In some in- 

 stances the condition is found in one or both parents and in several 

 members of the same family, making it appear to be hereditary. It is 

 well known that animals may be sensitized by feeding them proteins 

 not usually present in their diet, as by giving guinea-pigs horse serum or 

 the flesh of other animals. 



