Local Organ Hypersensitiveness

Abstract

Although there is a considerable and significant literature on the problems of general hypersensitiveness the known facts concerning local hypersensitiveness are few. The early work of Koch, 1 Calmette and Guerin, 2 and v. Pirquet 3 on the tuberculin reaction, the demonstration by Arthus 4 of skin necroses after repeated injection of foreign proteins, the work of Gay 5 on the typhoidin reaction and finally the work of Swift. 6 Dochez and Stevens, 7 and MacKenzie and Hanger, 8 and many others have helped our understanding of local changes in the reactivity of the skin. Furthermore, clinical observations have attested to the fact that apparently arrested areas of inflammation in various parts of the body have been relit by the introduction of the homologous noxious substance into distant sites. Experimental work along similar lines attempting to produce altered reactivity in other organs than the skin has not yielded uniformly positive results.

From a review of previous attempts to produce local hypersensitiveness it seemed that the critical requirement was the maintenance of a set of experimental conditions which would keep antigen in juxtaposition to body cells for a relatively long period of time. The structure of the anterior chamber of the eye presents a feature which probably allows this condition to be fulfilled. We had observed that heterologous erythrocytes when injected into the anterior chamber of the rabbit's eye would persist for several days. On this account the anterior chamber of the eye was the initial area chosen to test for the production of local hypersensitivity.

A number of workers in ophthalmology have attempted to explain certain types of conjunctivitis and keratitis on the basis of “ocular anaphylaxis”.