Handbook of medical entomology . jection of a foreign protein bythe fly (, with the flrst bite) sensitizes the body to that subsequent injection at any point in the skin gives rise to alocal expression of systematic sensitization. Such local sensitizationreactions have been described by Arthus and Breton, by Ham-burger and Pollack and by Cowie. The description of such a lesiongiven by the first named authors, in the rabbit, however, does notsuggest, histopathologically at least, a strong resemblance to thatof the black-fly. Such an explanation of many insect urticariasdeserves
Handbook of medical entomology . jection of a foreign protein bythe fly (, with the flrst bite) sensitizes the body to that subsequent injection at any point in the skin gives rise to alocal expression of systematic sensitization. Such local sensitizationreactions have been described by Arthus and Breton, by Ham-burger and Pollack and by Cowie. The description of such a lesiongiven by the first named authors, in the rabbit, however, does notsuggest, histopathologically at least, a strong resemblance to thatof the black-fly. Such an explanation of many insect urticariasdeserves further investigation, however, and may align them undercutaneous expressions of anaphylaxis to a foreign protein injectedby the insect. Depending on the chemical nature of the proteininjected, a specific chemotactic reaction like eosinophilia may ormay not occur. Viewed in this light the development of immunityto insect bites assumes a place in the larger problem of anaphylaxis. Lesions Produced by the Bite of the Black-fly 325. 174. Experimental lesion produced from alcohol-fixed flies, dried and ground into apaste with glycerin. 326 Lesions Produced by the Bite of the Black-fly Summary In order to bring the results of the foregoing studies together,the author appends the following resume of the clinical data pre-sented in the first paper. The black-fly, Simulium venustum, inflicts a painless bite, withecchymosis and haemorrhage at the site of puncture. A papulo-vesicular lesion upon an urticarial base slowly develops, the fullcourse of the lesion occupying several days to several weeks. Markeddifferences in individual reaction occur, but the typical course in-volves four stages. These are, in chronological order, the papularstage, the vesicular or pseudovesicular, the mature vesico-papular orweeping papular stage and the stage of involution terminating in ascar. The papule develops in from 3 to 24 hours. The early pseudo-vesicle develops in 24 to 48 hours. The mature vesico-
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectinsectp, bookyear1915
