﻿The 
  Biological 
  Significance 
  of 
  Anaphylaxis. 
  133 
  

  

  Eichards* 
  of 
  Philadelphia, 
  we 
  analysed 
  this 
  type 
  of 
  action 
  more 
  fully, 
  and 
  

   were 
  able 
  to 
  reduce 
  the 
  main 
  features 
  of 
  the 
  complex, 
  as 
  seen 
  iu 
  different 
  

   species, 
  to 
  an 
  action 
  predominantly 
  on 
  two 
  tissues 
  — 
  stimulation 
  of 
  plain 
  

   muscle 
  fibres 
  to 
  intense 
  tonus, 
  and 
  a 
  poisoning 
  of 
  the 
  endothelium 
  forming 
  

   the 
  walls 
  of 
  the 
  capillaries, 
  with 
  the 
  result 
  that 
  the 
  blood 
  tended 
  to 
  collect 
  at 
  

   the 
  periphery 
  in 
  the 
  widened 
  capillary, 
  spaces, 
  while 
  the 
  plasma 
  escaped 
  

   through 
  the 
  abnormally 
  permeable 
  endothelial 
  cells. 
  With 
  some 
  poisons 
  the 
  

   injury 
  is 
  so 
  severe 
  that 
  the 
  blood 
  itself 
  escapes 
  from 
  the 
  capillaries 
  and 
  

   passes 
  into 
  the 
  tissues, 
  as 
  in 
  cases 
  of 
  severe 
  anaphylactic 
  shock 
  in 
  the 
  dog. 
  

  

  There 
  are 
  minor 
  differences 
  of 
  distribution 
  of 
  the 
  action 
  of 
  the 
  different 
  

   poisons 
  of 
  this 
  class, 
  but 
  the 
  fundamental 
  community 
  of 
  the 
  type 
  is, 
  I 
  think, 
  

   unmistakable. 
  To 
  this 
  common 
  type 
  of 
  toxic 
  action, 
  which 
  obviously 
  has 
  a 
  

   very 
  wide 
  pathological 
  importance, 
  the 
  anaphylactic 
  shock 
  conforms. 
  In 
  

   the 
  guinea-pig 
  the 
  action 
  on 
  the 
  plain 
  muscle 
  of 
  the 
  bronchioles 
  often 
  

   produces 
  such 
  rapid 
  death 
  that 
  the 
  rest 
  of 
  the 
  complex 
  has 
  not 
  time 
  to 
  

   develop 
  ; 
  in 
  the 
  dog 
  the 
  effect 
  on 
  plain 
  muscle 
  is 
  relatively 
  slight 
  or 
  wanting, 
  

   and 
  the 
  main 
  effect 
  is 
  that 
  on 
  the 
  blood-capillaries, 
  especially 
  in 
  the 
  liver. 
  

  

  It 
  is 
  of 
  special 
  interest, 
  for 
  our 
  immediate 
  purpose, 
  to 
  note 
  that 
  substances 
  

   having 
  this 
  type 
  of 
  action 
  are 
  liberated 
  by 
  injury 
  of 
  various 
  cells 
  and 
  tissues, 
  

   including 
  the 
  blood. 
  The 
  latter 
  in 
  clotting 
  acquires 
  an 
  evanescent 
  toxicity 
  

   of 
  this 
  type, 
  which 
  is 
  accentuated 
  by 
  rough 
  treatment 
  calculated 
  to 
  injure 
  

   the 
  corpuscles 
  and 
  platelets. 
  

  

  I 
  may 
  allow 
  myself 
  a 
  momentary 
  and 
  very 
  slight 
  digression, 
  to 
  mention 
  

   that 
  during 
  the 
  war 
  this 
  type 
  of 
  action 
  has 
  come 
  to 
  light 
  in 
  a 
  quarter 
  not 
  

   hitherto 
  suspected, 
  as 
  at 
  least 
  an 
  important 
  factor 
  in 
  some 
  of 
  the 
  conditions, 
  

   loosely 
  classified 
  as 
  " 
  shock," 
  following 
  massive 
  injury 
  of 
  the 
  soft 
  tissues, 
  

   from 
  which 
  poisonous 
  substances 
  appear 
  to 
  be 
  absorbed 
  into 
  the 
  circulation. 
  

  

  This 
  striking 
  resemblance 
  between 
  the 
  anaphylactic 
  shock 
  and 
  the 
  

   effects 
  of 
  certain 
  protein 
  derivatives, 
  formed 
  the 
  basis 
  of 
  the 
  alternative 
  

   theories 
  of 
  the 
  nature 
  of 
  anaphylactic 
  shock, 
  to 
  which 
  a 
  very 
  large 
  pro- 
  

   portion 
  of 
  the 
  work 
  on 
  the 
  subject 
  has 
  been 
  devoted. 
  These 
  other 
  theories 
  

   have 
  in 
  common 
  the 
  supposition 
  that 
  a 
  toxic 
  substance 
  or 
  condition 
  arises 
  

   in 
  the 
  blood, 
  to 
  which 
  the 
  symptoms 
  are 
  immediately 
  due. 
  Some 
  have 
  

   supposed 
  that 
  the 
  symptoms 
  following 
  the 
  re-injection 
  of 
  the 
  antigen 
  were 
  

   due 
  to 
  the 
  liberation 
  in 
  the 
  blood 
  of 
  toxic 
  products 
  of 
  protein 
  hydrolysis.! 
  

   In 
  an 
  earlier 
  form 
  of 
  this 
  conception 
  it 
  was 
  supposed 
  that 
  the 
  formation 
  

   of 
  the 
  complex 
  of 
  antigen 
  and 
  antibody 
  brought 
  the 
  former 
  into 
  relation 
  

  

  * 
  ' 
  Journ. 
  of 
  Physiol.,' 
  vol. 
  52, 
  pp. 
  110, 
  355 
  (1918). 
  

  

  + 
  Bichet, 
  ' 
  C. 
  E. 
  Soc. 
  de 
  Biol.,' 
  vol. 
  61, 
  p. 
  1005 
  (1909) 
  ; 
  Vauglian, 
  ' 
  Zeitsehr. 
  f. 
  Immun.,' 
  

   vol. 
  11, 
  p. 
  673 
  (1911) 
  ; 
  also 
  'Protein 
  Split 
  Products,' 
  New 
  York, 
  1913. 
  

  

  