154 ANAPHYLAXIS 



which suggests that the anaphylactic reaction may be brought 

 about in consequence of an interaction between sessile antibodies, 

 i. e., antibodies which are still in union with the cells which gave rise 

 to their formation, and the corresponding antigen. This view is 

 supported by the experiments of Schultz and notably of Dale on the 

 one hand, and of Manwaring, Voegtlin, and Bernheim on the other. 

 Dale thus showed that the virgin uterus of sensitized guinea-pigs, 

 after being freed from serum by thorough perfusion with Locke's 

 solution, will exhibit a definite rise of tonus in response to extreme 

 dilutions of the respective antigen, and that one dose of the specific 

 antigen, in sufficient concentration to produce a "maximal" response 

 of the anaphylactic plain muscle, completely desensitizes the latter 

 to further doses of any dimensions. Corresponding results were 

 obtained with the isolated lungs of the animal after perfusion with 

 Ringer's solution. While in the guinea-pig the localization of the 

 anaphylactic reaction in the plain muscle tissue has thus been 

 established, Manwaring, Voegtlin, and Bernheim have conclusively 

 demonstrated that in the dog the primary effect takes place in the 

 liver. If the liver of a sensitized dog is thus excluded from the 

 general circulation, the reinjection of the corresponding antigen 

 does not produce shock; if, however, at this time the clamp on the 

 hepatic artery is removed anaphylactic symptoms promptly develop. 



While these experiments of course strongly suggest the existence 

 of sessile anaphylactic antibodies in the tissues which have been 

 studied, it does not follow that an interaction between antigen and 

 antibody may not also occur in the circulation with consequent pro- 

 duction of shock. That the anaphylactic antibody finds its way into 

 the circulation can hardly be disputed, and one could conceive that 

 under certain quantitative conditions it could here play the role of 

 an antitoxin. This possibility has indeed not yet been satisfactorily 

 worked out. At the same time one could also imagine that this 

 combination is at first only a loose one and that it might yet be broken 

 by the sessile antibodies with consequent anaphylactic shock. 

 Opposed to the idea that the free antibody might play the role of an 

 antitoxin, i. e., of a protective substance, is the fact that as a conse- 

 quence of the interaction between antigen and antibody in the test- 

 tube, a reaction product develops which on injection into the normal, 

 non-sensitized animal will develop anaphylactic symptoms. 



Further work along these lines will be necessary before a true 



