A Skin Reaction to Pneumotoxin. 



93 



of the literature has yielded only two references to the phe- 

 nomenon, one by Grocco in 1904, the other by Grocco's pupil, 

 Frugoni, in 1910. 



The phenomenon consists in the separation of the contractions 

 of the diaphragm and intercostal muscles by a definite, though 

 variable, time-interval. As far as has been observed, the move- 

 ment of the abdomen precedes that of the thorax. In well- 

 developed types of the phenomenon the abdominal wall may 

 have reached the expiratory phase before the intercostal muscles 

 begin to contract. In other instances, the lower intercostal 

 muscles take up the movement of the abdomen and the con- 

 traction spreads as a wave over the thorax. 



Asynchronism of the respiratory movements has so far been 

 observed only in lobar pneumonia. It possesses grave prognostic 

 significance. Nearly all patients who develop it die. Usually it 

 appears late in the disease. Though generally associated with 

 other indications of severity, it may give the first intimation that 

 the disease is likely to be fatal. 



164 (1342) 



A skin reaction to pneumotoxin. 



Charles Weiss and John A. Kolmer. 



[From the McManes Laboratory of Experimental Pathology, Uni- 

 versity of Pennsylvania.] 



The work reported is a part of the studies on the properties 

 of pneumotoxin and its probable r61e in the pathology of lobar 

 pneumonia. Previous investigators (Clough, Weil, Steinfield and 

 Kolmer) working with dried, autolyzed or heat-killed pneumococci 

 failed to elicit any constant, specific reaction in cases of lobar 

 pneumonia. The present authors used the endocellular hemolytic 

 toxin of the pneumococcus freshly prepared for each test by 

 dissolving the washed living organisms (Type I) in solutions of 

 sodium choleate. Guinea pigs previously sensitized with sub- 

 lethal doses of pneumotoxin or with the serum or lung exudate of 

 dogs suffering from experimental lobar pneumonia, reacted to the 



