If normal rabbits are injected intravenously with sublethal doses of cholera vibrios, the micro-organisms usually "localize" in the intestinal mucosa, the blood and most of the extra-enteric tissues becoming free from the injected bacilli. The resulting enteric carriers of the comma bacillus usually do not show recognizable cholera symptoms. If, however, these carriers are injected intravenously with alien bacterial products, such as Bacillus coli or Bacillus proteus filtrate, a violent local hemorrhagic or desquamating enteritis results, often accompanied by severe or even fatal systemic toxemia. This nonspecific or synergistic local and constitutional reaction was first described in 1924 by Sanarelli,1 who characterized it as an "epithelial shock" or "epithelaxie."
"Sanarelli anaphylaxis" is not apparently confined to the enteric tissues, however. Shwartzman,2 Sickles,3 and Freund and Smith,4 for example, found that a wide range of bacterial products injected intracutaneously into rabbits will render the injected skin areas
SYNERGISTIC ETIOLOGY OF POLIOMYELITIS. JAMA. 1934;103(10):757-758. doi:10.1001/jama.1934.02750360033017