1 8 



Scientific Proceedings (55). 



The initial dose according to this interpretation produces a 

 state of responsiveness or sensitiveness which reacts to the attack 

 or action of the re-injection, by the production of free-bonded 

 substances and split products, poisonous secretions or eliminations 

 which result in the intoxication or functional disturbance which 

 may end in death. 



A practical application of our observations is made to the 

 administration of therapeutic sera. The re-injection of split 

 products of the B. tuberculosis obtained by chemical agents and 

 electrolysis have given interesting results. 



Protocol i : A possible Delayed Anaphylaxis following 



Re-injection with B. tuberculosis. 

 Large black mongrel dog, weight 25 lbs., was injected April 25, 

 1 912, intravenously with 4 mg. No. 634 bovine culture of the B. 

 tuberculosis contained in 4 c.c. of physiological saline solution. 

 The dog was sick for about two months, with loss of weight. 

 It then recovered and gained weight and strength and appeared to 

 be in good health. Nine months after this recovery and 12 after 

 the first injection, the dog was apparently normal and had in- 

 creased in strength and weighed 33^ lbs. This dog was re- 

 injected on April 16, 191 3, with 4 mg. intravenously of a virulent 

 bovine culture (Ravenel) of the B. tuberculosis, contained in 4 c.c. 

 of physiological saline solution. This dog appeared well imme- 

 diately after the re-injection and remained so for ten days. Twelve 

 days after the re-injection bloody mucus stools were observed. 

 It then became quiet and three days later, 17 days after the re- 

 injection, it was found dead with some signs of hemorrhage from 

 the nostrils. The autopsy showed a very few tubercles in the 

 pleura covering the upper lobes of the lungs. The liver was 

 fatty and the lungs extremely congested. The spleen and other 

 organs were negative. The cause of death in this case would 

 possibly appear to be a persistent or delayed constitutional re- 

 action, rather than due to the 4 mg. of the tubercle bacilli per se. 

 The initial dose set up a condition in the host which responded to 

 the re-injection by setting free ferments and split products or 

 secretions, which thus produced an auto-intoxication as outlined 

 in the beginning of this paper. 



