136 ANAPHYLAXIS, ALLERGY OR HYPERSENSITIVENESS 
penia, frequently with a temporary partial or complete loss of coagu- 
lability of the bloocP followed by a secondary febrile rise of tempera- 
ture and a leukocytosis in which polymorphonuclear leukocytes and 
frequently the eosinophiles- are increased. The lesions may resemble 
those of an acute toxic gastro-enteritis. Ecchymoses and ulcers 
may be found occasionally in the stomach and intestines, together 
with parenchymatous changes in the liver and particularly the kidney 
which may lead eventually to degeneration of these organs. 
Anaphylaxis.— Wells'* has emphasized the necessity of distinguishing 
between reactions simulating anaphylaxis in many details, and the 
elucidation of a symptom-complex which, when fully exhibited, may 
be regarded as a true anaphylactic reaction. The criteria to be real- 
ized comprise the following: 
1. The observed toxicity of the injected material must depend upon 
the sensitization of the animal, /. e., the substance must not produce 
similar symptoms in non-sensitized animals. 
2. The symptoms produced must be those characteristic of anaphy- 
lactic intoxication as observed in the usual reactions with typical 
soluble proteins, being therefore the same for all antigens with the 
same test animal, but difl'ering characteristically with each species 
of animal. 
3. It should be possible to demonstrate passive sensitization with 
the serum of sensitized animals. 
4. It should be possible to demonstrate typical reactions in the 
virgin guinea-pig uterus strip. 
5. It should be possible to demonstrate amelioration or prevention 
of the bronchial spasm in guinea-pigs by proper use of atropin and 
epinephrine. 
6. The possibility that the observed symptoms are caused by 
capillary thrombosis or embolism must be excluded. 
7. After recovery from anaphylactic shock there should be exhibited 
a condition of desensitization under proper conditions. 
The symptoms of anaphylaxis may be masked or even prevented by 
the administration of certain drugs immediately before the reinjection 
— of these, epinephrine, atropin, chloral hydrate and similar narcotics 
are considered particularly efficient. In the guinea-pig this efl'ect is not 
improbably referable to a relaxation of the bronchial musculature. In 
general the phenomenon has no anti-anaphylactic basis. 
The Nature of the Anaphylactic Reaction.— The anaphylactic reac- 
tion, in common with other immunological reactions, appears to 
depend upon the elaboration of a specific antibody produced in response 
to the parenteral introduction of an antigen. The antibody is usually 
referred to as the anaphyhictin and the antigen the anaphi/lactogeii. 
The latter so far as available evidence shows, must be a protein. 
1 Biedl and Kraus: Wien. klin. Wchnschr., 1909, 22, .363. Friedberger and Grobcr: 
Ztschr. f. Immunitatsforsch., orig., 1911, 9, 216. 
- Moschcowitz: New York Med. Jour., 1911, 83, 15. 
3 Physiological Reviews, 1921, 1, 1. 
