BLOOD DENSITY IN GUINEA PIG ANAPHYLAXIS AND IN HAY FEVER ARTIFICIALLY INDUCED*

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1 BLOOD DENSITY IN GUINEA PIG ANAPHYLAXIS AND IN HAY FEVER ARTIFICIALLY INDUCED* J. H. BLACK AND HARDY A. KEMP From the Department of Bacteriology and Preventive Medicine, Baylor University School of Medicine, Dallas, Texas A survey of the literature reveals many reports of investigation of the various constituents of the blood in allergic persons. Many of these were done in the absence of allergic reactions, many do not indicate whether reactions were present at the time of the investigation, while a few were done to determine differences that might be due to the reaction. In conditions such as eczema it may make no difference whether lesions are present at the time of the blood study but in hay fever, asthma, and, possibly, even urticaria it may. Even the casual observer of patients suffering from a severe attack of asthma must recognize the possibility of a large water loss from the body, yet the records do not show that this has been considered in determining the concentration of various blood constituents. Certainly, it would seem that any comparison of figures obtained during an asthmatic attack and in the period of freedom would have to be correlated with changes in blood concentration. In addition there is abundant evidence of marked change locally and possibly generally in the vascular system during an allergic attack. Local vasodilation and edema are regular findings. Changes in plasma volume would be expected as the result of changes in the caliber and permeability of the vessels. Irrespective of loss of water from the body as a result of muscular effort there should be changes in blood concentration due to the allergic reaction itself. In order to determine if such volume changes do occur the * Read before the Fifteenth Annual Convention of the American Society of Clinical Pathologists, held at Kansas City, Missouri, May 8 to 10, Received for publication June 1,

2 BLOOD DENSITY IN GUINEA PIG ANAPHYLAXIS 301 blood density was studied during an attack of artificially induced hay fever. In such an investigation it was recognized that large loss of water due to prolonged muscular activity need not be considered and that it might be possible to determine if the allergic reaction, of itself, was accompanied by blood volume change. Because of its sensitivity the method of Barbour and Hamilton 1 was used. This consists of the timing of a ten cubic millimeter drop of blood as it falls thirty centimeters through a mixture of xylene and bromobenzene. Using a solution of potassium sulphate of known density as the standard the density of the blood is determined from its falling time. One of us (J. H. B.), sensitive to ragweed pollen, while at rest and without food for six hours, and without water for two hours, introduced into his nostril sufficient ragweed pollen extract to produce within three minutes sneezing, edema of the nasal mucosa and profuse serous discharge. Blood density determinations were made by Dr. Fred T. Rogers before, immediately after the onset of sneezing, and at intervals following. From chart 1 it will be seen that there was an immediate concentration of blood from a specific gravity of to This gradually declined until at the end of thirty minutes it had returned to its original level and clinical evidence of reaction had disappeared. Pollen extract again was instilled into the nostril and a second increase in density, equal to the first, occurred at once and returned to its original level a little more rapidly than before. Since each change of equals 2 per cent change in water concentration it is evident that approximately 3.4 per cent of the water content of the blood left the vessels so rapidly that its passing was completed before blood could be drawn, though this was done as quickly as possible after the first sneeze occurred. This finding we felt had a bearing not only on the subject of "blood chemistry" in allergic persons but also on the question of the mechanism of the production of the allergic reaction. There is still much argument as to the possible identity of allergy and anaphylaxis. Concentration of the blood in anaphylactic animals has been reported 2 * * as a regular accompaniment

3 302 J. H. BLACK AND HARDY A. KEMP of the anaphylactic reaction. The similarity of vascular reaction in these two conditions might add a small bit of evidence of their identity. It was felt that some criticism might be made of the methods which had been used in determining blood concentration in anaphylactic animals. Manwaring, Hosipean and Beattie 2 used dogs in their experiments and used as a criterion changes in red cell count. They concluded that the results were unsatisfactory because of "hepatic sinusoidal stasis." Simond's 3 hemoglobin determinations in dogs were used to indicate the amount of concentration. He found some concentration of blood in most of the animals but a decrease in a small percentage of the dogs. Since it is known that the characteristic change in anaphylactic so IIlllllSlll 1 X-. MINUTES 0 S CHABT 1 dogs is a marked change in the hepatic circulation this makes interpretation of red cell counts and hemoglobin determinations difficult and open to question. Drinker and Went 4 used guinea pigs and demonstrated by a modification of the dye method that "if asphyxia was prevented no change occurred in blood volume. When shock was exceedingly severe and some degree of asphyxia unavoidable the blood volume reading during the height of the asphyxia, was low due to poor mixing of the injected dye." However, their determinations were made with sodium barbital as an anaesthetic and with intravenous injection of curare and artificial respiration was used to prevent the development of asphyxia, all of which might materially modify the reaction of the vascular system. In the hope that we might be able to follow the blood volume change we used the method of Barbour and

BLOOD DENSITY IN GUINEA PIG ANAPHYLAXIS 303 Hamilton and avoided the tremendous influence of the liver in dogs by using guinea pigs in the following tests. 70 60 50 40 30 20 10!

4 BLOOD DENSITY IN GUINEA PIG ANAPHYLAXIS 303 Hamilton and avoided the tremendous influence of the liver in dogs by using guinea pigs in the following tests ! : 1 5 MINUTES CHABT MINUTES CHAET 3 Eighteen guinea pigs weighing approximately three hundred grams each were injected intra-peritoneally with 1 cc. of 1 per

5 304 J. H. BLACK AND HARDY A. KEMP cent egg white. Thirteen of these were given their shock injection after two and one-half weeks while five were injected at the end of three weeks. Shock was produced by intra-cardiac or intra-peritoneal injections. In four cases death occurred too promptly for adequate study but the others gave readings similar to those shown in charts 2, 3 and 4. Before the injection of the shocking dose of egg white the normal blood density was determined with several drops of blood from the ear. Because 9 fttfffli mil mil ii in in ii mill inn iiiiiiiiiiiiiiiiiiinm aoffflffl i [ [ [ II11111 EBB 70 IrfTml W w B 1 1 i ill 1 50 fffiffil lltf H m ^HtHfll mitiwllif fil m 3o fiifflfflill III 1111K M 20 l I 1 jlill/lliill^ io l [ 11 j[ 1111 [ [ [ [ \ lintl MINUTES CHABT 4 bleeding from the ears stopped almost at once after the shock injection subsequent bleedings were done by drawing small amounts from the heart. Some animals died more quickly than others but in all those living long enough for even a few determinations the increase in density may be seen. Chart 2 illustrates the change in two animals who showed only a moderate degree of anaphylaxis. Chart 3 shows the change in three animals with fatal anaphylaxis

6 BLOOD DENSITY IN GUINEA PIG ANAPHYLAXIS 305 with death occurring quickly. Chart 4 is the record of two cases whose death was more delayed. DISCUSSION Barbour 6 stated that in his work on animals he had found the emotional reaction of the animal making a tremendous difference in the concentration of the blood. If this were true it would make the method impracticable except for animals under anaesthesia and this we wished to avoid because of its possible effect on the blood concentration. Reference to the charts shown will en DU sn ;; i :: ^ k j * ' "»,. \ 4.0 ::::.:::.:.::::::..::: :""!"""[""::':"". 5. ;_.::: :::.fc" _:_::: 30 : :._;: '.-.. : - - v.._: LL:.::;;:. s : :. : : : : : : _,j...»... $s ;;_ 20 """" "" " "~ 10 ; " I " " c M NUTES F ^ * ' L CHART 5 demonstrate that the emotional reaction in guinea pigs made no appreciable change in their blood concentration since several readings made before the shock injection show very small variations. In these animals, at least, we feel it has been demonstrated that the method is entirely practicable. In spite of the repeated withdrawal of small amounts of blood the density of the blood increased markedly in all pigs. In contrast with these findings are those in three normal pigs as shown in chart 5. These animals, bled in the same manner as the others at five minute intervals, withdrawing the blood from

7 306 J. H. BLACK AND HARDY A. KEMP the heart show a definite decrease in density, possibly due to the influence of flow of fluid from the tissues to replace that lost by the bleeding. Since the normal trend of the curve is downward because of repeated bleedings the increase in density in the anaphylactic animal becomes more significant. CONCLUSIONS The method of Barbour and Hamilton was found to be well suited to this type of investigation since it makes possible frequent rapid determinations with very small amounts of blood and detects small changes in density which could not be so certainly detected by other methods. Marked increase in blood concentration was found in all pigs, the increase roughly paralleling the intensity of the reaction. The increase in blood concentration noted in artifically induced hay fever offers one more point of similarity of allergy in men and anaphylaxis in animals. REFERENCES (1) BARBOUR, H. G., AND HAMILTON, W. F.: The falling drop method for determining specific gravity. J. Biol. Chem., 69: 625M (2) MANWARING, W. H., FRENCH, W. 0., AND BRILL, S.. Mechanism of the increased hepatic resistance during canine peptone shock. J. Immunol., 8: (3) SIMONDS, J. P.: The relation between blood volume and blood pressure in anaphylactic shock. Am. J. Physiol., 72: (4) DRINKER, C. K, AND WENT, S.: Blood volume in guinea pigs during anaphylactic shock. Am. J. Physiol., 88: (5) BARBOUR, H. G., AND HAMILTON, W. F.: The falling drop method for determining specific gravity; clinical applications. J. A. M. A., 88:

Hemoglobin regeneration as influenced by diet and other factors*

G E O R G E H. WH I P P L E Hemoglobin regeneration as influenced by diet and other factors* Nobel Lecture, December 12, 1934 Experiments usually have a past history or a genealogical sequence, and it