ANTIANAPHYLAXIS 143 
There is some justification at the present time, although this ^•ie^y is 
opposed by many observers, to regard certain cHnical and pathological 
symptoms of bacterial infections — particularly fever— and the produc- 
tion of specific pathological lesions — as manifestations of anaphylaxis, 
as outlined by Vaughan.^ The body is sensitized to the alien protein, 
or to the invasive bacteria. The anaphylactic reaction takes place 
when the homologous protein is brought into contact with the sensitized 
individual through the proper channels. It will be remembered that 
the incubation period in many bacterial infections was explained by 
Vaughan as the time elapsing between the arrival of the alien protein 
(bacterial cells) in the tissues of the host and the maturing of a specific 
proteolytic enzyme that would effect their disintegration. The symp- 
tomatology of bacterial infections, according to Vaughan, is largely due 
to the liberation of the anaphylatoxin incidental to the lysis of the 
residual organisms. 
Artificial or Acquired Hypersensitiveness.— The phenomena grouped 
for convenience as acquired hypersensitiveness in man are met with 
chiefly in connection with the administration of the sera of animals 
immunized for therapeutic purposes. Three types of anaphylactic 
reaction may be recognized: 
1. Sudden Death. ^Behnng, Kitasato and other observers had 
noticed many years ago, when antitoxin was first used on a large 
scale, that animals immunized with large amounts of tetanus or 
diphtheria toxin occasionally succumbed to a subsequent small dose 
of the homologous toxin, although the blood serum of these animals 
contained much specific antitoxin. A very few human cases are on 
record in which the administration of antitoxin for therapeutic pur- 
poses, either for immunization or curatively, has been followed within 
a few minutes or hours by death. Already in 1896 Gottstein- had 
collected 12 which followed the injection of diphtheria antitoxin, 
8 of whom were diphtheritic, 4 healthy individuals.'' The symp- 
toms are essentially those observed in sensitized experimental animals 
which, it will be remembered, may die shortly after the injection of the 
homologous protein. The commonly accepted explanation is that the 
indi\'idual has become sensitized in some unexplained manner to the 
proteins of the serum in which the antitoxin is developed. The injec- 
tion of the serum in such persons is equivalent to the reinjecti(m of the 
homologous protein in sensitized animals. The resulting reaction is an 
anaphylactic reaction. It must be remembered that the antitoxin 
content per se of such serum has nothing to do with the phenomenon/ 
1 Loc. cit. 
2 Therap. Monatschr., 1896, 10, 269. 
3 It has been claimed that 1 in every 50,000 injections of therapeutic sera may 
react very violently, or even fatally. By observing the precautions mentioned in the 
section on prophylaxis (p. 145), no hesitation should be considered in using prophylactic 
and curative sera whenever indicated. 
■• For an excellent discussion of this and other phases of anaphylaxis, sec Gurd: 
Infection, Immunity and Inflammation, 1924, 
