xii CONTENTS 



PAGE 



sonic index estimations. Opsonins and tuberculosis. Treatment by auto- 

 inoculation. The value of opsonic index determinations. The value of 

 vaccine therapy. Prophylaxis. Different types of infection and the 

 logic of vaccine therapy in each type. The production and standardiza- 

 tion of vaccines. The tuberculins. 



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 Richet 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. Variation in different animals. 

 Anaphylactic antigen. Specificity of anaphylactic reaction. Quantita- 

 tive relations. Variations depending upon method of administration. 

 Anti-anaphylactic state. Prevention of anaphylaxis by drugs. Passive 

 sensitization. Conditions governing its accomplishment. Quantitative 

 studies of Doerr and Russ. 



CHAPTER XVI. ANAPHYLAXIS Continued. FURTHER DEVELOPMENT AND 



THEORETICAL CONSIDERATIONS 384 



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 RELATED TO 

 ANAPHYLAXIS. Toxicity of normal serum. Toxin hypersusceptibility. 



CHAPTER XVII. ANAPHYLAXIS Continued. BACTERIAL AXAPHYLAXIS AND 



ITS BEARING ON THE PROBLEMS OF INFECTIOUS DISEASE . . 412 



Early work on sensitization with bacterial protein. Technique for 

 sensitizing with bacteria. Revision of our ideas of li 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 understanding of infectious disease. Friedberger 's 

 interpretation. Bacterial toxaemia. Is the bacterial antigen the matrix 

 for the poison? 



CHAPTER XVITT. ANAPHYLAXIS Continued. THE CLINICAL SIGNIFICANCE 



OF ANAPHYLAXIS .......... 428 



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 448 



THERAPEUTIC USE OF DIPHTHERIA ANTITOXIN. Statistical results. 

 Amounts to be injected. Amount of antitoxin normally present in the 



