The Vascular Processes in the Shwartzman Phenomenon As Observed in Pulmonary Reactions

[摘要] The Shwartzman reaction to a filtrate of B. typhosus was studied in the lungs of rabbits. The following findings were revealed in the experiments: 1. 1. The intratracheal injection of a filtrate of B. typhosus produces an acute alveolitis. Four hours after the intratracheal injection intravenously injected bacteria and India ink are localized in the alveolar spaces because of an inflammatory alteration of permeability of the pulmonary blood vessels.2. 2. Twenty-four hours after the intratracheal injection of filtrate the inflammatory reaction is subsiding. At this period, when the reactivity of the prepared site in the Shwartzman reaction is at its peak, there is no alteration of permeability when measured by intravenous injections of bacteria or India ink.3. 3. When the “shocking” dose of filtrate is given intravenously into animals which have been previously prepared by an intratracheal injection of filtrate, the changes produced by the “shocking dose” are confined to the pulmonary blood vessels, and consist of widespread thrombosis of arterioles and venules, dilatation of the capillaries, engorgement of the capillaries with granulocytes, and disruption and swelling of the endothelium. There is no alteration of the alveolar exudate from that seen twenty-four hours after the preparatory injection. When bacteria or India ink are injected intravenously at this period, they are fixed within the blood vessels, and the India ink is plastered to the endothelium. The reaction is non-specific, for there is equal fixation of Staphylococcus aureus and B. typhosus in the lungs at this time.4. 4. When bacteria were injected intravenously into rabbits which had received both the preparatory injection and the shocking injection of a filtrate of B. typhosus , embolic pneumonias were present three days after the injection of bacteria. B. typhosus produced a lobular consolidation, and Staphylococcus aureus produced abscesses.From these findings it is concluded that the Shwartzman reaction occurs within the blood vessels of the lung as the result of an alteration of the blood vessels by the preparatory injection and that the hemorrhagic congestion that characterizes the Shwartzman reaction is secondary to the widespread thrombosis. The non-specific fixation of the bacteria indicates that the reaction is not due to an antigen-antibody reaction.

[学科分类] 生物科学（综合）