62 



Scientific Proceedings (79). 



where the identity of protein in question was obvious from the 

 history of the case, or where the different methods have permitted 

 to disclose its nature by a special investigation, the treatment 

 consists in immunization of patient by repeated injections of the 

 specific protein. In those cases where the nature of protein could 

 not be determined, it was suggested to use the blood of the patient, 

 as a carrier of antigen. If the presence of antigen in the blood of a 

 sensitized individual causes anaphylactic phenomena, it is evident 

 that during the periods of freedom from symptoms the patient's 

 blood is probably free from circulating antigen. This fact is lost 

 sight of by many authors who in applying the auto-serum therapy 

 presumably on the basis of the above described theoretical con- 

 siderations collect the blood at regular intervals without any 

 regard as to whether such blood contains free circulating antigen 

 or not. 



Much has been written of late on therapy by parenteral intro- 

 duction of nonspecific proteins 1 and it is possible, if the observa- 

 tions of the clinicians are correct, that the therapeutic effects of 

 promiscuous injections of patient's own serum are due to some 

 other phenomena than that of immunization by the circulating 

 antigen. 2 Though in such cases apparently injections of normal 

 horse serum can be expected to give just as good results, human 

 serum is evidently to be preferred in order to avoid an additional 

 sensitization to a horse protein. In so much, however, as the 

 authors base their therapy on hypothesis that serum contains the 

 circulating antigen, it seems essential to withdraw the blood at 

 the time when antigen is present in it. 



On the other hand, should the removed portion of the blood 

 contain the circulating antigen, what is the rationale of injecting 

 it back practically immediately (as some authors do), when the 

 remaining blood of the patient contains at the time considerably 

 larger amount of antigen already. On the basis of our experimental 

 data we wish to suggest that the blood be withdrawn immediately 

 preceding, during, or immediately after the anaphylactic reaction; 



1 Miller and Lusk; Smith; Jobling and Petersen. Journ. A. M. A., 1016, p. 

 1753-58. 



2 M. H. Kahn and H. W. Emsheimer, Arch, of Internal Medicine, Vol. xviii,, 

 PP- 445- 



