Frank A. Simon

Technic on intracutaneous tests and results of routine tests in normal persons

Abstract 1. 1. In making intracutaneous tests, the importance of chemical as well as bacteriologic cleanliness is emphasized. The need for all-glass syringes is defined, and a convenient rack for segregating and labelling the syringes is described. 2. 2. When this improved technic is applied to the study of normal, nonallergic individuals, many positive skin tests are obtained. 3. 3. The importance of this observation to the study of allergic patients is discussed.

A species nonspecific antigenic factor in mammalian serums: A preliminary report☆

Abstract 1.1. A patient with vasomotor rhinitis was found to be highly sensitive to horse serum and equally sensitive to the serums of a variety of different mammals. 2.2. Local passive transfer of hypersensitiveness to these serums was successful. 3.3. Skin tests to the raw muscle extract of chicken, mackerel, codfish, and to the serum of the frog and of men who belonged to different blood groups were negative. 4.4. The identity of the antigenic principle present in the various mammalian serums which gave positive skin tests was apparently demonstrated by desensitization of passively sensitized skin sites. 5.5. The antigen is not soluble in strong alcohol; it is precipitated by complete saturation with ammonium sulphate but not by one-half saturation. Boiling destroys it to a great extent but not completely. It is not affected by heating to 56° C. for one hour. 6.6. The presence of a species nonspecific antigenic factor in mammalian serums is not incompatible with the existence of other factors which are species specific. 7.7. The source of exposure responsible for this patients hypersensitiveness to serum is discussed. The inhalation of horse (or other mammalian) dander and the ingestion of mammalian meat are considered. 8.8. Intradermal tests with serum in concentration greater than 1:1,000 may be dangerous. 9.9. The intradermal test in this case was about one thousand times more sensitive than the scratch test. 10.10. The conjunctival test was somewhat less sensitive than the scratch test. 11.11. A purified horse serum globulin solution contained the antigen but in much lower concentration than normal horse serum. 12.12. Antiserums made from mammals other than the horse will not necessarily eliminate serum accidents.1. 1. A patient with vasomotor rhinitis was found to be highly sensitive to horse serum and equally sensitive to the serums of a variety of different mammals. 2. 2. Local passive transfer of hypersensitiveness to these serums was successful. 3. 3. Skin tests to the raw muscle extract of chicken, mackerel, codfish, and to the serum of the frog and of men who belonged to different blood groups were negative. 4. 4. The identity of the antigenic principle present in the various mammalian serums which gave positive skin tests was apparently demonstrated by desensitization of passively sensitized skin sites. 5. 5. The antigen is not soluble in strong alcohol; it is precipitated by complete saturation with ammonium sulphate but not by one-half saturation. Boiling destroys it to a great extent but not completely. It is not affected by heating to 56° C. for one hour. 6. 6. The presence of a species nonspecific antigenic factor in mammalian serums is not incompatible with the existence of other factors which are species specific. 7. 7. The source of exposure responsible for this patients hypersensitiveness to serum is discussed. The inhalation of horse (or other mammalian) dander and the ingestion of mammalian meat are considered. 8. 8. Intradermal tests with serum in concentration greater than 1:1,000 may be dangerous. 9. 9. The intradermal test in this case was about one thousand times more sensitive than the scratch test. 10. 10. The conjunctival test was somewhat less sensitive than the scratch test. 11. 11. A purified horse serum globulin solution contained the antigen but in much lower concentration than normal horse serum. 12. 12. Antiserums made from mammals other than the horse will not necessarily eliminate serum accidents.

Further observations on The Nature of Allergy

Abstract 1.1. The development of typhoid agglutinins was studied in a series of 23 normal nurses and in 20 patients with asthma. 2.2. The resulting curves show that the agglutinin response in asthma is slightly lower than normal. 3.3. The search for agglutinins in asthmatic serums for such other organisms as Staphylococcus aureus, hemolytic streptococci, and non-hemolytic streptococci gave negative results in all except one patient who had arthritis at the same time with her asthma. 4.4. Intradermal skin reactions to histamine dilutions were slightly larger among 85 asthmatic patients than among 23 nurses, but the differences were small, and the results seem to indicate that asthmatic patients are slightly more sensitive to histamine than normal. 5.5. Treatment with histamine did not help in the few patients studied. 6.6. The differences between patients with asthma and normal persons in their responses to typhoid vaccine and in their reactions to histamine are small.

SOME BASIC PRINCIPLES AND PROBLEMS OF CLINICAL ALLERGY

It is not the purpose nor is it possible in this presentation to consider most or even many of the known facts and unsolved problems of clinical allergy. Rather it is my hope to consider briefly some of the more important and more fundamental aspects of the known and the unknown in clinical allergy. In a relatively new and rapidly developing field it is natural that there should be some controversy and honest differences of opinion. It is only with more time and more careful work that such differences can at least partially be resolved. Without going into a philosophic definition of knowledge, I think it necessary to point out that the line of cleavage between the true and the false in clinical medicine is sometimes not as sharp as one would like to have it but that it often seems to consist of different degrees of probability. Pragmatically, this