To the Editor.—I would like to comment on the article entitled "Anaphylactic Shock in Man" by Hanashiro and Weil which appeared in the February issue of the Archives (119: 129, 1967).
Having observed anaphylaxis first-hand and in consultation for many years, I must draw attention to uncertainties in the basic premise of this otherwise careful and detailed analysis. First, the major clinical events of anaphylaxis occur within minutes and usually, if the patient survives, have evaporated within a few hours suggesting that the major physiological events in these cases could have abated by the time the studies began several hours later. Second, true anaphylaxis... that which results from an immunological calamity... is classical in its manifestations regardless of cause and such manifestations are urticaria, angio-edema, nasal obstruction, and rapidly progressive bronchospasm, dyspnea, and unconsciousness. These occur within minutes and, if properly treated (or, if lucky!), recovery is rapid.