AUergia or Anaphylaxis 109 



bodies, which inhibited the activities of the respective immune 

 bodies by whose stimulation they were produced. 



The reactions which when repeated may lead to immunity and to 

 the formation of antibodies seem to be followed by constitutional 

 disturbances much more profound than would be supposed from the 

 apparent freedom from symptoms manifested by the animal. As 

 early as 1839 Magendie observed that if a rabbit was given an 

 injection of albumin, and then, some days later, a second injection, 

 it was made very ill and might die. About 1900 Mattson in private 

 conversation called the author's attention to the fact that when 

 guinea-pigs used for testing antitoxic serums were subsequently 

 injected with another dose of serum, they commonly died. Not 

 being understood, the matter was not thought worthy of pubhcation. 

 Otto* speaks of this fatal action of serums as the "Theobald Smith 

 phenomenon," the fact having first been pointed out to him by Smith. 



The first to realize the importance of the condition seem to have 

 been For tier and Richet,t who studied the effect of extracts of the 

 ■ poisonous tentacles of actiniens upon dogs which were found to die 

 more quickly and from smaller doses given at a second injection 

 than at the first. To this increase of sensitivity to the poison 

 brought about by the initial dose they gave the name anaphylaxis 

 {av negative, <pv\a^i,s protection, destroying protection or break- 

 ing down the defenses). 



The therapeutic employment of diphtheria antito:xic serum was 

 scarcely popularized before the medical profession was shocked by 

 the sudden death of the healthy child of a noted German professor 

 after a prophylactic injection, and in 1896 Gottsteinf was able to 

 collect eight deaths following the use of the serum, four of them 

 being persons not ill with diphtheria, von Pirquet and Schick§ also 

 pointed out that in a certain proportion of cases the injection of horse- 

 serum in man is followed by urticarial eruptions, joint-pains, fever, 

 swelling of the lymph-nodes, edema and albuminuria, these symptoms 

 usually appearing after an incubation period of eight to thirteen 

 days, and constituting what they call the " serum disease,'' or allergic. 

 Sometimes these reactions are immediate; sometimes death appears 

 imminent, and, as has been observed, death sometimes occurs. 



The investigation of the subject was taken up in 1905 by Rosenau 

 and Anderson, II who pursued it with great interest and industry, 

 by Gay,** Gay and Southard, ff and others. 



* von Lenthold, " Gedenkschrift," Bd. i, pp. 9, 16, 18. 



t "Compte rendu de la Soc. de Biol, de Paris," 1902. 



t"Therap. Monatschrift," 1896. 



§ "Die Serumkrankheit," Leipzig and Wien, 1905. ' 



II "Journal of Medical Research," 1906, xv; p. 207; "Bull. No. 29 of the 

 Hygienic Laboratory," Washington, D. C., 1906; "Bull. No. 36," 1907, Ibid.; 

 "Jour. Med. Research," 1907, xvi, No. 3, p. 381; "Jour. Infectious Diseases," 

 1907, IV, No. I, p. 1, "Jour. Infectious Diseases," 1907, vol. iv, p. 552. 

 ** "Jour. Med. Research," May, 1907, xvi, No. 2, p. 143. 

 tt Ibid., June, 1908 x,vin. No. 3, p. 385. 



