IDIOSYNCRASIES AND ANAPHYLAXIS 169 



ingestion of egg albumen, and in certain babies the administration 

 of cows' milk; further, also, the remarkable symptom-complex, 

 which is usually designated as angioneurotic edema, the long list 

 of urticarias which follow the ingestion of lobster, fish, oysters, 

 cheese, and strawberries; certain bacterial exanthemata, certain skin 

 affections of pregnancy, the dermatitis of satin-wood- workers, the phe- 

 nomena of fagopyrismus (buckwheat poisoning), certain anomalous 

 drug reactions, etc. 



Here we have entered the very midst of the idiosyncrasies which 

 in former years seemed shrouded in impenetrable mystery, and which 

 now, in view of our knowledge of the principles underlying anaphyl- 

 axis, seem so readily accounted for on this basis, and as merely 

 being the expression of an anomalous reaction on the part of certain 

 individuals to the parenteral introduction of alien proteins. The 

 question, of course, still remains to be answered why one person and 

 not all others react in such an anomalous manner to stimuli which 

 after all we must regard as normal. At the present we can merely 

 theorize on these points, it is true, but we can do so with the knowl- 

 edge that we have, at least, a basis which unquestionably is sound, 

 and the time is evidently not far off when this chapter, which was 

 only a few years ago so obscure, will be one of the best understood 

 in physiological pathology. 



This is not the place to enter into a detailed account of the various 

 idiosyncrasies that we have just briefly passed in review, but it may 

 be permissible nevertheless, before concluding our present chapter, 

 to show by a few examples that we have already gained somewhat 

 more than a clinical basis for our belief that anaphylactic action is 

 responsible for the clinical pictures which we observe. 



Especially interesting in this connection are the asthmatic phe- 

 nomena which occur in some persons when exposed to certain exhala- 

 tions. Remarkable examples of this order have been described. 

 Schittenhelm thus mentions the case of an engineer who invariably 

 was attacked with "asthma" when he was obliged to enter a tunnel 

 that was under construction, while he was otherwise free from any 

 discomfort. Another person was subject to asthma in one city and 

 not in another only a few miles distant. To this order also belong 

 those individuals who become asthmatic when they enter a horse- 

 stable, or even when they sit in a carriage behind a horse. It is 

 interesting to note that a number of persons who experienced a 



