xii CONTENTS 



PAGE 



value of vaccine therapy. Prophylaxis. Different types of infection 

 and the logic of vaccine therapy in each type. The production and 

 standardization of vaccines. 



CHAPTER XV. ANAPHYLAXIS. FUNDAMENTAL FACTS 358 



The relation of immunity to hypersusceptibility. Various kinds of 

 hypersusceptibility. Historical development of our knowledge of these 

 phenomena. The work of Eichet and others. The phenomenon of 

 Arthus. The phenomenon of Theobald Smith. Experimental produc- 

 tion of the anaphylactic state. Laws governing the condition as at 

 first determined. Symptoms of experimental anaphylaxis in guinea 

 pigs. Autopsy findings and causes of death. Changes in blood pres- 

 sure. Changes in temperature. Leucopenia. Diminution of comple- 

 ment. Symptoms in rabbits and dogs. Anaphylactic antigen. Spe- 

 cificity of anaphylactic reaction. Quantitative relations. Variations 

 depending upon method of administration. Anti-anaphylactic state. 

 Prevention of anaphylaxis by drugs. Passive sensitization. Condi- 

 tions governing its accomplishment. Quantitative studies of Doerr 

 and Buss. 



CHAPTER XVI. ANAPHYLAXIS Continued. FURTHER DEVELOPMENT AND 



THEORETICAL CONSIDERATIONS ....... 385 



Theory of Gay and Southard. Besredka's theory. Gradual develop- 

 ment of the antigen-antibody conception. Quantitative work. Identity 

 of sensitizing and toxic substances. Idea of sessile receptors. Ana- 

 phylaxis and precipitins. The work of Vaughan. Diminution of alexin 

 during anaphylactic shock. Toxic substances obtained by action of 

 active serum. Friedberger 's ' ' anaphylatoxin. ' ' Obtained from pre- 

 cipitates. Obtained from bacteria. Is the mechanism of anaphylaxis 

 intravascular or cellular? Precipitins and albuminolysins. Writer's 

 opinion. THE MECHANISM OF ANTI-ANAPHYLAXIS. Nature of ana- 

 phylactic poison. Peptone shock. PHENOMENA CLOSELY BELATED TO 

 ANAPHYLAXIS. Toxicity of normal serum. Toxin hypersusceptibility. 



CHAPTER XVII. ANAPHYLAXIS Continued. BACTERIAL ANAPHYLAXIS AND 



ITS BEARING ON PROBLEMS OF INFECTIOUS DISEASE . . . 410 

 Early work on sensitization with bacterial protein. Technique for 

 sensitizing with bacteria. Bevision of our ideas of ' ' endo-toxin. " 

 Vaughan 's work on toxic protein split-products. Friedberger 's ana- 

 phylatoxin. Methods of production. Quantitative proportions which 

 must be observed. Time and temperature conditions. Bearing of this 

 work upon our underst nding of infectious disease. Friedberger 's 

 interpretation. Bacteria, toxaamia. Is the bacterial antigen the matrix 

 for the poison? 



CHAPTER XVIII. ANAPHYLAXIS Continued. THE CLINICAL SIGNIFICANCE 



OF ANAPHYLAXIS . . . . . . . . . . 426 



Serum sickness. Accelerated reactions and immediate reactions. Meth- 

 ods of avoiding anaphylaxis in antitoxin injections. Anaphylaxis and 

 bacterial vaccines. Asthma and hay fever. Sensitiveness to contact 

 with certain animals. Possible anaphylactic reason for eclampsia. 

 Sympathetic ophthalmia. Diagnostic reactions. Tuberculin reaction. 

 Luetin reaction. Discussion of tuberculin reaction. Experimental ana- 

 phylaxis with tuberculin. Diagnostic use of anaphylaxis. 



CHAPTER XIX. THERAPEUTIC IMMUNIZATION IN MAN. THERAPEUTIC USE 



OF DIPHTHERIA ANTITOXIN 446 



Statistical results. Amounts to be injected. Amount of antitoxin 

 normally present in the human blood serum. PRACTICAL CONSIDERA- 

 TIONS CONNECTED WITH DIPHTHERIA ANTITOXIN PRODUCTION AND 

 STANDARDIZATION. Toxin production. L and L + doses. Methods of 

 determination. Production of antitoxin. Standardization of antitoxin, 



