168 ANAPHYLAXIS IN ITS RELATION TO DISEASE 



have long been familiar may possibly be due to similar causes. 

 Recent investigations have shown that such is actually the case, and 

 with the recognition of this possibility an unexpected ray of light has 

 reached one of the darkest corners of our clinical rubbish room 

 where have reposed for centuries the time-honored and mystic 

 " idiosyncrasies.' ' 



Especially interesting in this connection are the observations which 

 have been made in the so-called "hay fever ," or pollen disease, as it 

 would be more appropriate to term the malady. As is well known, 

 certain individuals are annually attacked with irritation of the 

 mucosa of the nose, giving rise to paroxysms of sneezing, and later 

 with a similar irritability of the pharynx and the trachea, leading 

 to asthmatic disturbances of greater or less severity. The occurrence 

 of these attacks is intimately associated with the time of the year at 

 which certain plants (belonging to the order of the Graminese, also 

 Ambrosia and Solidago) come into blossom, and is due, as Elliothson 

 already pointed out in 1831, to the absorption of some constituent 

 of the pollen of the respective plants. Weichardt and Wolff-Eisner 

 then pointed out (1905 and 1906) the close similarity between 

 the symptom-complex in question and the serum sickness of 

 v. Pirquet and Schick, and suggested that it also could readily be 

 explained upon the basis of anaphylaxis. As a matter of fact it is 

 possible in a susceptible individual to call forth a typical attack at 

 any time either by the introduction of a suspension of the corres- 

 ponding pollen into the conjunctiva, or by its subcutaneous applica- 

 tion, in a manner quite analogous to the tuberculin test. Here as there 

 the amount of material which will suffice to bring about a reaction 

 is remarkably small. Wolff -Eisner thus reports that a typical 

 response will follow the application of but two drops of a 0.2 per 

 cent, solution of pollen, and Lubbert mentions that in highly sus- 

 ceptible individuals TUiTTnT milligram even may produce symptoms. 



Closely related to pollen fever are no doubt also those curious 

 asthmatic conditions which have been noted in some individuals 

 following the inhalation of Witte peptone, after the ingestion of 

 egg albumen, strawberries, blueberries, gooseberries, various legu- 

 minous vegetables, lobster, chocolate, cheese, as also on exposure to 

 certain exhalations, such as those of horses, in connection with attacks 

 of constipation, etc. To the same category evidently belong also 

 those curious cases of diarrhea which in some persons follow the 



