32 



Scientific Proceedings (36). 



2i (43i) 



The cause of serum anaphylactic shock and some methods of 



alleviating it. 



By JOHN F. ANDERSON and W. H. SCHULTZ. 



[From the Hygienic Laboratory, U. S. Public Health and Marine- 

 Hospital Service, Washington, D. C.~\ 



Last July a series of experiments was begun to find out, if 

 possible, the main cause of anaphylactic shock. It was already 

 known that the phenomena were primarily respiratory, but it was 

 not proven whether the origin of the trouble was central or 

 peripheral. In order to clear up this point a number of guinea 

 pigs were given artificial respiration, and their blood-pressure 

 recorded from the carotid by means of a mercury manometer. 

 It was proven that the cause of death is asphyxia which is periph- 

 eral in origin. Some animals died in spite of all that could be 

 done for them while in others the symptoms were less acute and 

 yielded to certain forms of treatment. In the more acute forms 

 of anaphylactic shock the respiratory muscles of the chest and the 

 diaphragm act without the lungs fulfilling their function. That 

 the latter do not function is shown both by the slight motion of 

 the respiratory tambour, connected with the trachea, and by the 

 dark venous color of the carotid blood. In spite of the dyspneic 

 movements the animal gradually dies from weak heart resulting 

 probably from the lack of oxygen supply. In the less acute forms 

 of shock, however, we were able to save the animals by artificial 

 respiration, recovery being indicated by the carotid blood assum- 

 ing its normal color, the blood-pressure returning to normal and 

 instead of the spasmodic action of the diaphragm there ensued an 

 even, rhythmic respiration. It was also noted that in those cases 

 not yielding to artificial respiration the chest became fixed and 

 the rhythmic action of the bellows caused no change in the posi- 

 tion of the walls of the chest cavity. 



About this time Auer and Lewis 1 published a preliminary note 

 in the August number of the Journal of the American Medical 

 Association stating that this asphyxia is due to an inspiratory im- 

 mobilization of the lungs, since, as they suggest, the lungs, upon 



1 Acute Anaphylactic Death in Guinea Pigs. Its Cause and Possible Prevention ; 

 a Preliminary Note. Jour, of the American Med. Assn., 1909, liii, 458. 



