ANAPHYLAXIS 125 



large amount of the toxic element is produced at once, 

 and the injurious effects of anaphylaxis are manifest. 



It is quite likely that many of the symptoms of in- 

 fection heretofore attributed to toxins are due to ana- 

 phylaxis, and the poisons generated in the decomposi- 

 tion of the protoplasm of the germs by antibodies of the 

 infected organism. 



The practical lesson of this matter then is that great 

 care should be exercised in the administration of the 

 various antitoxins and serums to avoid the production 

 of anaphylaxis. It would be better, therefore, to ad- 

 minister large initial doses of serum rather than small 

 doses which must needs be repeated. When a second 

 dose of serum becomes necessary, it should follow the 

 first at as short an interval as possible, so that time shall 

 not have elapsed for the development of hypersuscep- 

 tibility. If it be known that one has had a previous 

 administration of a particular serum at some former ill- 

 ness, another administration of that serum should be 

 undertaken with caution. A very minute dose should 

 be given and the patient closely watched for signs of 

 anaphylaxis. Should these not arise within an hour or 

 so, a full dose may then be given. 



