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Fatal Anaphylactic Shock

B. Hugh Buff, M.D.
JAMA. 1961;175(10):925. doi:10.1001/jama.1961.03040100089031.
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To the Editor:—  Concerning the letter from Doctor Luton, not only is the type of test used in testing for sensitivity to horse serum controversial—i.e., conjunctival test versus skin test versus history— but also the proper initial dilution of the testing antigen and the amount of solution used for the test also vary according to the investigator. Some authorities advise 0.01 cc. antigen for each intradermal skin test; others advise 0.02, 0.05, and up to 0.1 cc. The latter dosage is that which appears on the instructions for skin testing which come with the antitoxin.I feel that 0.05 cc. to 0.1 cc., particularly after the catastrophe reported in the article mentioned, is a dosage that is too high. The drug manufacturers should be instructed to revise their directions on horse serum preparation to the effect that no more than 0.01 to 0.02 cc. of any given dilution of the


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