The isolated hearts of guinea pigs sensitized to horse serum have been shown to react characteristically upon exposure to small amounts of antigen. The cardiac rate is temporarily accelerated and transient alterations in amplitude of contraction are to be observed. Electrocardiographic abnormalities, previously recorded by remote leads during anaphylactic shock in the intact animal, have been recorded by direct leads from the isolated perfused hearts of sensitized animals during this reaction. An additional effect of anaphylaxis in the isolated heart of the guinea pig is reported: a striking reduction in the rate of flow through the coronary vessels. The anaphylactic reaction of the isolated heart of the guinea pig has been compared with the action of histamine upon the same preparation and the effect of atropine upon each has been observed. The implications of certain quantitative differences in the influence of atropine upon these reactions are discussed.
Differential diagnosis between the various forms of meningeal or central nervous system disease has not become simpler as our knowledge of the pathology and chemistry of these conditions has increased. While it is relatively easy to diagnose clinically the acute inflammatory or purulent types of disease from those of a less acutely inflammatory nature, the differentiation between the diseases comprising each group is still clinically and chemically confused. The clinical picture of epidemic, pneumococcal, influenzal or streptococci meningitis is, as a rule, distinct from that of epidemic encephalitis, anterior poliomyelitis, polioencephalitis or tuberculous meningitis.Bacteriologically, the distinction in the former group is clearly enough defined. Chemically, the evidence is less definite in both groups. Differentiation between meningitis and meningismus, tetany and certain types of birth injuries at times may be very difficult. The determination of the primary lesion in instances of combined cardiorenal and meningeal conditions is often impossible, either clinically or with the aid of chemical investigation. A changed relation in the sugar concentration in blood and spinal fluid seemed at first to offer a differential point between poliomyelitis and encephalitis-two diseases often clinically confused.It must be recognized that it is the level of the cerebrospinal axis involved, not the type of condition, that determines this changed relation between blood and spinal fluid sugar.There is reason to believe that the permeability of the choroidal cells is affected in varying degree by different types of physical disturbance, and that they are not always equally permeable to all elements entering into the composition of the blood.
Anaphylaxis in the isolated, perfused hearts of cats has been shown to be accompanied by a considerable, though transient, increase in coronary flow. This result is contrasted with that observed in the hearts of guinea pigs and rabbits in which the coronary arteries are constricted during anaphylaxis. Attention is directed to the fact that, in the hearts of these three species, the effects of anaphylaxis and of histamine are qualitatively parallel. The characteristic anaphylactic response in the isolated hearts of guinea pigs has been evoked: (a) in the organs removed from immune animals, (b) by each of two antigens (horse serum and egg albumen) under conditions of double sensitization, and (c) upon exposure of the hearts of passively sensitized animals to the type-specific polysaccharide of the pneumococcus. It is evident that, among the effects of anaphylaxis upon smooth muscle in various organs, there must be considered that upon the coronary arteries.
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