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A new hypothesis on the pathogenesis of vernal catarrh
SOCIETY
279
PROCEEDIKQS
Ragweed pollen extracts modified by t,he four above-mentioned methods were used in therapy. Protection against hay fever was obtained by each of the four types of extract. The formalized extract appeared to be more denatured than the other three. When compared to the regular alkaline saline extract, larger dosage of the denatured extracts could be given, the constitutional reactions were fewer and t,hose that did occur were definitely delayed, milder, and appeared only when larger dosages were given. Local reactions at the sit,e of injection were also delayed and milder. Direct skin tests were less. These differences were most apparent with the formalized extract. Serologic studies by passive transfer showed that these modified extracts did not neutralize sensitive serum as did regular saline extracts. Measured by this standard, formalized and heated extracts showed the greatest change. Further, the serums of patients treated with modified estracts showed those characteristic changes from the antetreatment serums which were reported by us a year ago. We have then definite evidence of the chemical modification by clinical and serologic test! definite evidence of the therapeutic effectiveness by clinical and serologic tests, as well as evidence of stability of extract and a definite lessening of constitutional reactivity.
A New Hypothesis COOKE, X.D.
on the Pathogenesis of Vernal Catarrh.
ROBERT
A.
&cause of its seasonal exacerbation, attempts have been made to explain ‘ ’ vernal catarrh ’ ’ as an allergy of the hay fever type, that is, due to pollens. Our studies of such cases in years gone by have never supported this idea. Hence the prcscnt study of 21 cases was undcrtaken on a new theory. The conception finally developed that perhaps Ternal catarrh was an allergy analogous to hyperplastic sinusitis; in other words, a bacterial allergy. That it is an allergy seems indicated by the facts of antecedent allergy in 10 of the 21 cases, of other past or present allergies in the personal history of 10 cases, by the uniform presence of eosinophile cells in the mucoid discharge from the eye and the commonly found increase of eosinophiles in the blood. The present evidence as far as it goes rests upon the satisfactory clinical improvement following removal of infected foci such as tonsils, adenoids, and teeth, and upon the response to treatment with autogenous vaccines. This study is not complete and final proof of t,he theory is not claimed, but the thesis is presented at this time to permit others to attempt therapeutic measures directed along this line.
279
PROCEEDIKQS
Ragweed pollen extracts modified by t,he four above-mentioned methods were used in therapy. Protection against hay fever was obtained by each of the four types of extract. The formalized extract appeared to be more denatured than the other three. When compared to the regular alkaline saline extract, larger dosage of the denatured extracts could be given, the constitutional reactions were fewer and t,hose that did occur were definitely delayed, milder, and appeared only when larger dosages were given. Local reactions at the sit,e of injection were also delayed and milder. Direct skin tests were less. These differences were most apparent with the formalized extract. Serologic studies by passive transfer showed that these modified extracts did not neutralize sensitive serum as did regular saline extracts. Measured by this standard, formalized and heated extracts showed the greatest change. Further, the serums of patients treated with modified estracts showed those characteristic changes from the antetreatment serums which were reported by us a year ago. We have then definite evidence of the chemical modification by clinical and serologic test! definite evidence of the therapeutic effectiveness by clinical and serologic tests, as well as evidence of stability of extract and a definite lessening of constitutional reactivity.
A New Hypothesis COOKE, X.D.
on the Pathogenesis of Vernal Catarrh.
ROBERT
A.
&cause of its seasonal exacerbation, attempts have been made to explain ‘ ’ vernal catarrh ’ ’ as an allergy of the hay fever type, that is, due to pollens. Our studies of such cases in years gone by have never supported this idea. Hence the prcscnt study of 21 cases was undcrtaken on a new theory. The conception finally developed that perhaps Ternal catarrh was an allergy analogous to hyperplastic sinusitis; in other words, a bacterial allergy. That it is an allergy seems indicated by the facts of antecedent allergy in 10 of the 21 cases, of other past or present allergies in the personal history of 10 cases, by the uniform presence of eosinophile cells in the mucoid discharge from the eye and the commonly found increase of eosinophiles in the blood. The present evidence as far as it goes rests upon the satisfactory clinical improvement following removal of infected foci such as tonsils, adenoids, and teeth, and upon the response to treatment with autogenous vaccines. This study is not complete and final proof of t,he theory is not claimed, but the thesis is presented at this time to permit others to attempt therapeutic measures directed along this line.