Hemorrhages in Skin Lesions After Intravenous Injection of Starch

Abstract

When rabbits are injected intravenously with cholera vibrios and on the following day the same material, or B. coli or proteus bacilli, is again injected intravenously, hemorrhages occur in the intestines at the site of the localization of cholera vibrios. This hemorrhagic phenomenon was discovered by Sanarelli. 1 Shwartzman 2 and Hanger 3 have shown that when certain species of bacteria or their products (B. typhosus, B. lepisepticum, B. coli, meningococci) are introduced into the skin of rabbits and one day later the same material injected intravenously, hemorrhagic necrosis occurs in the skin at the site of the first injection. The nature of this hemorrhagic reaction is still obscure. It seems reasonable to hope that the discovery of new substances capable of producing the reaction may throw light on the nature of the phenomenon. Sickles 4 observed that bacterial filtrates, of the second injection, can be replaced by a 0.1% agar suspension but not by purified agar, galactose, 10% gelatin, or India ink. Shwartzman 5 reported that mixtures of precipitinogen and serum containing homologous precipitins injected intravenously produce hemorrhage in the skin prepared by bacterial filtrates. Sickles did not express her view as to the mode of action of the agar suspension. It is possible that the action of agar is due to its colloidal character but we have found that a suspension of collodion particles, of less than 3 micra in diameter, injected intravenously did not produce hemorrhages in areas injected with bacterial filtrates.

It is known that the intravenous injection of agar mixed with fresh guinea pig serum and kept at 37°C. for 30 minutes produces anaphylactoid symptoms in guinea pigs, but agar alone or a mixture of agar and heated guinea pig serum are entirely inactive in this respect. Since starch, like agar, produces anaphylactoid symptoms in the guinea pig we wanted to find out if starch used as a second injection causes hemorrhagic phenomenon. Starch has the advantages that it is a relatively pure substance and its action upon the vascular system, when introduced into the blood stream, has been studied by physiologists (Bayliss and others).