Diphtheria Antitoxin. 



147 



70 (1652) 



Concerning anaphylaxis following the administration of diphtheria 



antitoxin. 



By J. BRONFENBRENNER and M. J. SCHLESINGER. 



[From the Department of Preventive Medicine and Hygiene, Harvard 



Medical School.] 



Sensitiveness of human beings to horse protein is fairly wide- 

 spread as indicated by numerous reports of cases of serum sickness 

 following administration of various therapeutic sera. The 

 impression is, however, that in diphtheria the danger from this 

 source is particularly slight. This comparative freedom of com- 

 plications of anaphylactic nature following the administration of 

 diphtheria antitoxin in emergency during the War has led to 

 abandoning the preliminary skin test for sensitiveness in certain 

 medical units. 1 



We attempted to approach experimentally this question of 

 apparent tolerance to anaphylaxis during diphtheria intoxication. 

 We have observed that sensitized guinea pigs receiving subcuta- 

 neously large excess of diphtheria toxin withstand the intravenous 

 injection of at least five lethal doses of the antigen to which they 

 were previously sensitized. This apparent resistance appears 

 about 12 to 14 hours after the administration of toxin and just 

 about the time when the outward symptoms of intoxication begin 

 to manifest themselves. 



With the view of eliciting the mechanism of this phenomenon 

 we have made thus far the following observations: 



The antitryptic titer of the blood of guinea pigs injected with 

 the toxin does not appreciably deviate from normal up to the time 

 of death. The mechanism regulating the antitryptic titer of the 

 blood remains unimpaired in these animals, however, since an 

 injection of antigen to which they are sensitized is followed by a 

 typical rise of antitrypsin. This rise of antitrypsin, incidentally 

 can be interpreted as indication that the humoral phase of the 

 anaphylactic response of the animals is not abolished by the 

 previous injection of toxin. 



Personal communication. 



