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November 25, 1992

Anaphylaxis and Stinging Insect Hypersensitivity

JAMA. 1992;268(20):2830-2833. doi:10.1001/jama.1992.03490200082008

THE TERM anaphylaxis was coined by the biologists Portier and Richet1 at the beginning of the 20th century. While guests aboard the yacht of the Prince of Monaco on a Mediterranean cruise, they injected dogs with the toxin of sea anemones in hopes of promoting tolerance to the venom's toxic effects on reinjection. To the contrary, the dogs had more severe reactions on repeat injection. The phenomenon was dubbed anaphylaxis ("ana" + "phylaxis" = antiprotection) to denote a state without protection. In the modern era, von Pirquet and Schick,2 when writing about serum sickness, observed that individuals who developed serum sickness after the administration of heterologous serum antitoxin produced in rabbits or horses, eg, diphtheria antitoxin, were prone to severe, acute reactions when reexposed to a smaller dose of the same serum that caused the original episode of serum sickness. Anaphylaxis is now the term applied to the clinical manifestations