ANAPHYLAXIS 



149 



and precipitin formation, without looking on the 

 precipitation itself as the cause of the rash. More 

 recently Doerr anci Russ, as the result of experi- 

 ments, hold that the phenomena of anaphylaxis are 

 due to a reaction between precipitins attached to 

 the tissue cells, and the precipitable antigen. The 

 anaphylactic shock is looked upon as an intracellu- 

 lar precipitin reaction. In quantitative investiga- 

 tions these authors showed that the amount of 

 anaphylactic antibody in the serum of rabbits 

 was always parallel to its precipitin content. It 

 has also been found that animals which do not form 

 precipitins, like white mice, are incapable also of 

 forming the anaphylactic antibody. Against the 

 view that precipitins have anything to do with 

 anaphylaxis in man is the fact that the symptoms 

 of serum disease appear within eight to thirteen 

 days following the first injection of horse serum, 

 whereas it requires about three weeks for precipi- 

 tins to appear in the blood in children after the 

 injection of horse serum. Furthermore, the forma- 

 tion of precipitins does not take place as readily 

 in man following the injection of horse serum as 

 it does in rabbits. In fact von Pirquet found that 

 sometimes even after the injection of 200 cc. there 

 was no production of precipitins. Finally it may 

 be remembered that there is no evidence that the 

 precipitin action is other than a test-tube phenom- 

 enon, or that it ever occurs in vivo. Friedemann 



