436 INFECTION AND RESISTANCE 



culiar so-called "idiosyncrasies" observed in many people who suffer 

 from urticarial skin rashes, gastro-intestinal difficulties, and even 

 severe systemic illnesses after certain varieties of food seem to de- 

 pend upon an acquired or possibly inherited hypersusceptibility to 

 the particular proteins involved, which, at certain times of abnormal 

 gastro-enteric conditions, can get into the circulation in small quan- 

 tity. It is not impossible, furthermore, that such unfortunate cases 

 as the severe forms of angioneurotic edema, which seem, at least in 

 part, to be associated with gastro-intestinal disturbance, and which 

 may be transmitted from mother to child, have their root in anaphy- 

 laxis. For this, however, we have only inference based on clinical 

 observation. 



ASTHMA AND HAY FEVER 



Conditions in which there seems to be more definite ground for 

 association with anaphylaxis are ASTHMA and HAY FEVER. In 

 asthma the analogy has been clearly set forth by Meltzer. 22 He 

 points out that in both asthma and anaphylaxis the symptoms consist 

 in a tonic stenosis of the small bronchioli of peripheral origin, and 

 that both conditions are favorably affected by the administration of 

 atropin. It is, of course, not certain, but it seems extremely likely 

 that so-called "nervous asthma" is nothing else than an anaphylactic 

 attack in a hypersusceptible individual when the particular protein 

 to which he is sensitive gains access either by the alimentary or 

 respiratory path. 



Very closely related to asthma is the condition known as "hay 

 fever." This disease has been of recent years most thoroughly stud- 

 ied by Dunbar. 23 Dunbar has ascertained that the hay fever preva- 

 lent in Europe is dependent chiefly upon a protein substance found 

 in the pollen of most grasses, while that of America, which occurs 

 chiefly in the autumn, is caused by the proteins of the pollen cells of 

 the ambrosiacese and solidaginese plants which are generally dis- 

 tributed on the North American continent and bloom in August and 

 September. The disease occurring in China is caused by another 

 plant, the Ligustrum vulgare. The suggestion that the disease was 

 due to anaphylactic action of these pollen proteins upon hypersus- 

 ceptible individuals was first made by Wolff-Eisner. 24 Dunbar has 

 gone into the question with great thoroughness, and has come to the 

 conclusion that the disease has much in common with anaphylaxis 

 though he believes that, in addition to a hypersusceptibility to the 

 pollen "toxin," there must be present in the patients, at the same 



22 Meltzer. Jour, of the A. M. A., Vol. 55, 1910, p. 1021. 



23 Dunbar. Berl. klin. Woch., Nos. 26, 28, 30, 1905; Zeitschr. f. Immuni- 

 tatsforsch., Vol. 7, 1907; Deutsche r.ied. Woch., Vol. 37, 1911, p. 578. 



24 Wolff- Eisner. "Das Heufieber sein .wesen u. seine Behandlung," 1906. 



