On the state of active mesenchyme in pneumonia

The fact that infection plays a role in the onset of pneumonia does not raise doubts at present. The importance of allergies in this disease, it seems to us, should also be considered proven. Even Wolf-Eisner considered the crisis in pneumonia as a phenomenon of anaphylactic shock based on leukopenia, a drop in temperature, and a decrease in blood complement. A number of facts speak in favor of the allergic theory of pneumonia: the violent reaction of the body at the onset of the disease, the rapid development of all pathological phenomena, the rapid coverage of the large anatomical units of the organ by the process, the fibrinous and hemorrhagic nature of the effusion itself, indicating the rapid onset of deep changes in the vascular walls (Davydovsky), herpes - expression on the skin of an increased sensitivity of the body to pneumococcal toxin (Konchalovsky), a tendency to relapse. The causative agents of pneumonia — pneumococci — are often found in the upper respiratory tract in healthy people and, therefore, sensitization of the body is quite possible. Children in the first months of life rarely get sick with pneumonia and very rarely give a positive skin reaction with pneumococcus, which can be explained by the lack of sensitization. The observed diseases of newborns, whose mother had pneumonia during pregnancy, can be explained by intrauterine passive sensitization, as a result of which the child is born with increased sensitivity to pneumococcus (Lauhe). Sirotinin believes that in the etiology of pneumonia “the predisposition associated with the constitution, generally characterized by a tendency to inflammatory processes (weakness of the active mesenchyme according to Bogomolets), is of great importance in the etiology of pneumonia, which is one of the distinguishing features of the allergic constitution”.