ANAPHYLAXIS 243 



vaguely of " vaccinating " against anaphylaxis by Besredka's 

 method, antianaphylaxis is in reality not a vaccination. 



Originally it was conceived as a true vaccination, and to 

 produce it Rosenau and Anderson made a series of injections 

 of 5 c.c. of serum intraperitoneally, starting before the period 

 of incubation for the anaphylactic state was up : they proceeded 

 as one does for antitoxins. 



But this idea had to be given up when it was seen that it 

 was sufficient to protect the guinea-pig to give it, not a series of 

 injections, but a single injection, not a large injection, but a 

 minimal one, -^ to -^ c.c., *.*., much less than the toxic 

 dose ; finally, and above all, that the resistance of the guinea- 

 pig develops the day after, or even some hours or minutes 

 after, the injection, according to the route employed. After 

 subcutaneous injection the resistance is present in four or five 

 hours ; after intradural injection in about two hours ; after 

 intraperitoneal in an hour and a half; ten to fifteen minutes 

 after intravenous injection. The shortness of this latter incu- 

 bation period may be employed to render the resistance more 

 and more complete : it is simply a question of repeating these 

 minute doses intravenously every ten or fifteen minutes : each 

 injection reinforces the effect of the preceding : this is the 

 method of " continuous vaccination " (vaccinations subintr antes). 

 It is not even necessary to inject by the veins : by taking a 

 little more time one may proceed by other routes and even 

 changing routes in successive doses. In this way a guinea-pig 

 may be protected from as many lethal doses of serum as is 

 desired (Besredka). 



In this there is the germ of a method which may be applied 

 to man. Certain sera, in particular the anti-plague serum, 

 have to be injected in large quantities, and as far as possible 

 by the veins. The anti-diphtheria serum is 500 times more 

 active, other things being equal, if introduced directly into the 

 circulation instead of under the skin (Berghaus). Besredka's 

 process promises to relieve such intensive serumtherapy from 

 all danger of death by anaphylaxis. 



What sort of immunity then is this which develops with such 



R 2 



