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Sigmund S. Greenbaum, M.D.
JAMA. 1940;115(10):847. doi:10.1001/jama.1940.72810360001009.
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Typical examples of local anaphylaxis are rarely observed in human beings.1 Although reported in connection with injections of vaccines (rabies, typhoid), antitoxin and toxinantitoxin, this is the first report of a local anaphylactic reaction developing after injections of histaminase.2

Local anaphylaxis (the Arthus phenomenon) is the "inflammatory reaction which occurs when an animal immunized against a protein is reinjected with the same antigen—it is caused by the presence of an antibody in the blood stream and tissues of the immunized animal and occurs when antigen and antibody meet in tissues" (Opie). It is by most sharply differentiated from the Shwartzman phenomenon. It is possible for such antibodies to be present only in the tissues, i. e. tissue sensitization without the presence of antibodies in the blood stream. It is perhaps on this basis that the passive transfer test performed with the serum obtained from my first patient was


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