Vol. 60, 1909 - University of North Carolina at Chapel Hill

94 THE CHARLOTTE MEDICAL JOURNAL.
erated reaction," in probably 30-40 % of be due to inherited hypersusceptibility from
the cases. These reactions are annoying the mother; in other words, inherited mabut
in no case have they resulted in death, ternal anaphylaxis? This maternal trans-
From the accumulated experience of others mission of anaphylaxis may also explain
it has been found that daily injections of the sudden and sometimes fatal symptoms
serum for a period of several days in no previously mentioned which one occasionway
increase the disturbances which are ally sees after first injections of horse serum
commonly expected about the eighth or in man. The demonstration of this matertenth
day; that with a day interval between nal function in guinea pigs by Rosenau
injections the rashes and febrile disturb- and Anderson is the first actual proof of
ances are more marked; three day inter- inherited hypersusceptibility. Inherited
vals cause still more marked symptoms; immunity has, as is well known, been preand
with four day intervals graver dis- viously demonstrated to be a fact,
turbances may be the result. The fact that Rosenau and Anderson
In the guinea pig, as we have noted, have been able to render guinea pigs imimmunity
to anaphylaxis may be secured mune to typhoid and colon bacilli by renin
one of two ways. Either by repeated dering them anaphylactic to proteid exinjections
of serum before the expected time tracts of the specific bacteria opens up a
for anaphylaxis to become established or new line of investigation into the specific
by the recovery of the pig from a second treatment of these and other infections,
injection during the stage of anaphylaxis. Passive bacterial immunity may be now a
In man, however, contrary to what one much easier problem than it has heretofore,
finds in guinea pigs, the evidences of hy- The time required for the development of
persusceptibilty are very variable in the anaphylaxis in the guinea pig and in cases
time of their appearance and, furthermore, of the "Serumkrankeit" in man bears a
repeated injections in the first ten days do close resemblance to the period of incubanot
develop immunity nor does recovery tion of some of the infectious diseases and
from a reaction render one immune to fur- anaphylaxis thus gives a possible explanther
injections. ation of this period. It is hardly a coinci-
Currie, after studying the effects of re- dence that the ten to fourteen day incubapeated
injections of horse serum in patients tion period of a number of the infectious
at the Glasgow Fever and Smallpox Hos- diseases corresponds so closely with the
pital at Belvidere, concludes that it is ap- time required to sensitize a guinea pig to a
parent from the facts detailed bj' him that foreign proteid. In those infectious disrepeated
injections of horse serum induce eases with a short incubation period, like
symptoms of hypersusceptibility in man, pneumonia, the crisis which usually occurs
but it is also apparent that the same facts about the tenth day may have a similar exlend
no countenance to the suggestion that planation. Those diseases which are prothe
death of persons suifering from diph- duced by soluble toxins, as tetanus and
theria is to be apprehended as the result of diphtheria, evidently do not come in this
repeated injections of antidiphtheric serum, same categor}'.
The fact that guinea pigs may be sensi- Finally, in regard to the injection of antized
by feeding them with horse meat or titoxin in view of the new light which we
horse serum brings up the interesting ques- have received on this subject by this recent
tion of the cause of certain cases of appar- work on anaphylaxis, nothing so far pubent
food poisoning in man. If man can lished should change our duty to a patient
be sensitized, like the guinea pig, by eat- suffering from diphtheria or tetanus. Aning
certain proteid substances, perhaps titoxin should be administered freely and
those interesting and obscure cases which should be given at frequent intervals, as it
one occasionally sees of sudden and some- has been shown (vide supra) that the untimes
serious symptoms habitually follow- toward effects increase in severity with the
ing the eating of fish, sea foods of various length of the interval between the injectkinds
and other articles of diet may be but ions. A fatal result is most unusual, but
a reaction of an individual in a state of an- it must be admitted that symptoms of colaphylaxis
towards the article eaten. lapse and even death may extremely rarely
Again, the maternal transmission of ana- occur after an initial dose of antitoxin,
phylaxis in guinea pigs is of great interest but, in view of the seriousness of diphthein
connection with the question of increased ria and tetanus and the marvellous effect
susceptibility in man to certain infectious serum therapy has had in reducing the mordiseases,
particularly tuberculosis. One talily of diphtheria especially, we should
often sees families in which tuberculosis not hesitate in the administration of antiacts
as a veritable scourge and the mem- toxin. However, as has been previously
bers of such a family seem to have no re- brought out, asthmatic patients seem to be
sistance to infection. May not these cases particularly prone to the serious untoward