652 ANAPHYLAXIS IN RELATION TO INFECTION AND IMMUNITY 



ficial immunization; the sum total of researches by various investigators 

 is to the effect that this skin test is an indication of hypersensitiveness 

 to typhoid protein, but cannot be accepted at present as an indication 

 of immunity (see page 622). 



ALLERGIC REACTIONS IN OTHER DISEASES 



Gonococcus Infections. In 1908 Irons 1 reported general and local 

 reactions in persons suffering from gonococcus infections following the 

 subcutaneous injection of gonococcal vaccines. This reaction has been 

 observed by Bruck 2 in epididymitis, by Reiter 3 in pelvic infections in 

 women, and also by other observers in other conditions. 



Experiments with glycerin extracts of the gonococcus prepared from 

 several strains, singly or combined in one preparation, have yielded 

 Irons 4 well-defined cutaneous reactions. These tests were conducted 

 after the method of von Pirquet's tuberculin test. 



Diphtheria. Shick has advocated the intracutaneous injection of a 

 minute dose of diphtheria toxin as a test for antitoxin in the serum of an 

 individual. If sufficient antitoxin is present, the toxin is neutralized 

 and no local disturbances are apparent; otherwise local inflammatory 

 areas may be observed. This test is not regarded as an allergic reac- 

 tion; a further description of it will be found in Chapter XIV, under 

 Diphtheria (see page 228) . 



Recently Dr. Moshage and I 5 have applied an anaphy lactic skin test 

 in diphtheria with a polyvalent antigen designated diphtherin; posi- 

 tive reactions were observed in about 70 per cent, of children and 35 per 

 cent, of adults, and the test was of practical interest mainly from the 

 viewpoint that the anaphylactic reaction may be mistaken for a positive 

 Schick reaction. 



ALLERGIC REACTIONS IN SERUM AND FOOD HYPERSENSITIVENESS 



Cutaneous and intracutaneous reactions have been utilized in the 

 diagnosis of hypersensitiveness to horse serum, as in horse asthma, and 

 to the proteins of various foods, as egg-albumen, milk, shell-fish, various 

 vegetables, etc. 



1 Jour. Infect. Dis., 1908, v, 279. 



2 Deut. med. Wchnschr., 1909, xxxv, 470. 



3 Zeitschr. f. Geburtsh. u. Kinderh., 1911, Ixviii, 471. 



4 Jour. Amer. Med. Assoc., 1912, Iviii, 931. 



5 Amer. Jour. Dis. Children, 1916, xii, 316. 



