ANAPHYLAXIS 405 



PHENOMENA CLOSELY BELATED TO ANAPHYLAXIS 



There are a number of well-defined phenomena of acquired 

 hypersusceptibility or sensitiveness which, in nature, seem closely 

 analogous to true anaphylaxis as we understand it to-day, but re- 

 garding the mechanism of which the opinions of experimenters are 

 still to some extent at variance. 



Among the most important of these is the toxic action of nor- 

 mal sera when injected into animals of another species a phe- 

 nomenon which is now generally accepted as belonging in principle 

 to the true anaphylactic phenomena, though this opinion is of com- 

 paratively recent formulation. The subject is of sufficient theoreti- 

 cal and practical importance to be considered in some detail. 



The older studies of phenomena belonging to this category fol- 

 lowed closely in the footsteps of experiments on transfusion, and as 

 early as 1666 a commission of the London Royal Philosophical So- 

 ciety reported deaths following transfusion, alleging intravascular 

 coagulation as the probable cause of death. 



The cause of death following injections of foreign whole blood, 

 blood cells, and serum has, since that time, occupied the attention of 

 many workers whose studies need not be reviewed for our present 

 purposes. Chief among them were Magnani, Brown-Sequard, Ma- 

 gendie, and, more recently, JSTaunyn, Landois, and Ponfick. 68 



The work of Landois is of special interest in that he worked 

 with blood serum free from cells, and attempted to correlate the 

 occurrences after the injection of animals with the action of the 

 serum upon the cellular blood elements in vitro. Landois observed 

 both the solution of hemoglobin and hemagglutination, and was 

 led to regard the action of serum upon erythrocytes as the pri- 

 mary cause of death after transfusion. His conception of the mech- 

 anism is apparently twofold. On the one hand, he believed that 

 when small quantities of blood were transfused, a formation of 

 fibrin (stroma-fibrin) was initiated in the stroma of the injured 

 erythrocytes which led to coagulation and thrombosis in the capil- 

 laries of the central nervous system and lungs. In the case of the 

 transfusion of rabbit's blood into dogs he attributed death to em- 

 bolism in the pulmonary vessels due to "Massenhafte Verklebung 

 der Kaninchenzellen im Hundeblut" or, in other words, to hemag- 

 glutination. 



Ponfick and others have disputed the validity of Landois' con- 

 clusions, but the basic principles of his explanations have been up- 

 held within recent years by workers who have gone over the same 

 ground with the aid of more modern methods. Two careful re- 



68 A brief historical review of this work can be found in the paper of 

 Coca, Vir chow's Arch. f. path. Anat., 1909, Vol. 196, p. 92. 



