BACTERIAL ANAPHYLAXIS 419 



guinea pigs, killing the animals after several hours and examining 

 the peritoneal exudates for their toxic properties. Centrifugalized, 

 cleared of bacteria, and injected intravenously into other guinea 

 pigs, these exudates produced the typical acute symptoms character- 

 istic of the poisons obtained in test-tube experiments. 



It was on these premises, then, that Friedberger 25 was led to 

 formulate his views of the nature of bacterial infections, which give 

 promise of introducing a new understanding of these diseases. It 

 has been shown in the researches upon serum anaphylaxis that the 

 injection of small quantities of a foreign protein may produce reac- 

 tions of temperature which simulate very closely those prevailing 

 in infectious diseases, and variations in the quantities injected, the 

 path of administration, and the interval between injections may lead 

 to conditions, local and systemic, which may affect, more or less 

 profoundly, many different organs and tissues of the body. These 

 matters we have considered in the general discussion of anaphylactic 

 phenomena. Friedberger now suggests that we may regard bacterial 

 infection, after all, as the presence in the body of a living foreign 

 protein in this case varying in distribution and quantity by reason 

 of the particular invasive properties of the given germ and the 

 balance between these and the resistance of the host. It is not neces- 

 sary, therefore, to assume that the character of the disease is deter- 

 mined by the existence of different preformed "endotoxins." He 

 believes that we may justly assume that the toxic substances appear 

 only after proteid cleavage of the bacterial bodies has been initiated 

 by the action upon them of the serum components, and that the ap- 

 parent specificity of the poisons, or differences between the toxemic 

 manifestations of various diseases, may depend, not on differences 

 in the pharmacological actions of these poisons, but rather upon 

 variations in the invasive properties of the bacteria, both as concerns 

 their quantitative distribution and their accumulation and localiza- 

 tion in the infected body. 



If we leave out of consideration bacteria w r hich, like the diph- 

 theria bacillus, produce true secretory poisons, it would be the ability 

 to gain a foothold in the body, the degree of invasive power, the pre- 

 dilection in the choice of a path of entrance, and the specific local 

 accumulation upon which the speed and quantity of anaphy la- 

 toxin production and absorption would depend, and which conse- 

 quently would give character to variations in the clinical pictures of 

 different diseases. Besides simplifying considerably our comprehen- 

 sion of bacterial toxemia this point of view again brings out the 

 great importance of the work of Vaughan, and of Vaughan and 

 Wheeler, on the non-specific poisonous fraction obtained by hydrol- 

 ysis of bacterial and other proteids. 



25 Friedberger. Loc. cit.; also Deutsche med. Woch., No. 11, 1911; Berl. 

 klin. Woch., No. 42, 1911. 



